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Query: UMLS:C0024523 (malabsorption)
 7,319 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In this review I have described the pathophysiology of allergic disorders of the gastrointestinal tract. Situations where the intestine cannot be a complete barrier to foreign allergens and antigens were discussed and etiological factors of gastrointestinal allergy were detailed. Clinical features of gastrointestinal allergy include diarrhea, vomiting, abdominal pain and colic, intestinal hemorrhage and malabsorption as well as symptoms and signs outside the gastrointestinal tract such as chronic rhinitis and asthma in the respiratory system, urticaria, angioedema and eczema as dermatological signs, headache, insomnia, hyperkinesis as central nervous system manifestations, failure to thrive and anaphylaxis as constitutional reactions. Milk allergy was discussed as an example of food allergy. Immunology of the gastrointestinal tract was presented, with examples of four types of hypersensitivity reactions, and gastrointestinal disturbances of immunodeficiency disorders and syndromes were named. Lastly, the autoimmune mechanism and the gut were described, with particular discussion of ulcerative colitis as an example of an autoimmune disease.
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PMID:The intestine in allergic diseases. 78 84

Enterokinase initiates digestion of protein by conversion of trypsinogen into trypsin. The interactions between enterokinase and trysin were investigated in 6 patients with intractable diarrhea of infancy and 34 children with celiac disease. The six infants between 2 and 3 months with intractable diarrhea of infancy had reduced mucosal enterokinase activity (9.5 +/- 4.8muM per gram of protein per minute) and reduced intraluminal trypsin activity (2.9 +/- 0.7muM per gram of protein per minute) as compared with healthy controls (109 +/- 34.2muM per gram of protein per minute and 14.3 +/- 5.8muM per gram of protein per minute) respectively. The activities of all enzymes returned toward normal following treatment with intravenous alimentation. The mucosal morphology of all pretreatment biopsies in all cases showed Grade III atrophy which improved. These findings suggest that enterokinase deficiency and reduced intraluminal trypsin activity in intractable diarrhea of infancy may be one of the contributing factors to protein malabsorption and consequent malnutrition. Thirty-four children with celiac disease were between the age of 9 months and 13 years. The 11 newly diagnosed patients with celiac disease demonstrated Grade III to IV atrophy of the mucosa. The 23 patients with treated celiac disease on a gluten-free diet showed a normal to Grade II atrophy. In both treated and untreated celiac disease the enterokinase activities and the intraluminal trypsin activity were within normal limits. The enterokinase activity in celiac disease is near normal in contrast to the marked reduction noted in intractable diarrhea of infancy even though the intestinal mucosa shows marked morphological alteration and the disaccharidase activities are greatly reduced in celiac disease. After a prolonged alimentary fast of up to 26 days on intravenous alimentation, two patients with intractable diarrhea of infancy showed improvement in the activities of enterokinase and trypsin. These findings demonstrate that enterokinase and trypsin activities in the gut were present and improved in the absence of oral feeding.
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PMID:The interrelationship of enterokinase and trypsin activities in intractable diarrhea of infancy, celiac disease, and intravenous alimentation. 80 41

In terms of a short review indications and applications of infusion therapy in gastroenterology (concerning vomiting, fistulas, diarrhea, ileus and peritonitis) are discussed. It is pointed out that in cases of water and electrolyte deficiency a rigid regimen is not reasonable. If possible a balance should be obtained. Parenteral nutrition is applied in obstructions of the upper gastrointestinal tract and in maldigestion and malabsorption.
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PMID:[Infusion therapy in gastrointestinal diseases]. 81 18

Nine cases of Mediterranean lymphoma with alpha heavy chain disease are described. All patients were young, aged between 11 and 22 years. Neither sex predominated in the series. The clinical presentation of the disease was either gastrointestinal, with chronic diarrhea and malabsorption, or neoplastic, with tumors frequently associated with either obstructive or perforative complications. Finger clubbing and retardation of physical growth (height and weight) and secondary sexual maturation were usually evident. The laboratory manifestations of the malabsorption syndrome were scant and generally not specific. The intestinal lesions predominated in the beginning of the small bowel, and their gross appearance varied from one case to another: diffuse thickening of the intestinal wall, alone or associated with tumors, or isolated segmentary tumors. Massive mesenteric lymph node enlargement was present in all cases; in some cases hepatic, splenic, or extra-abdominal lymph node spread was noted. Histologically, these lesions demonstrated a varied cellular morphology, but seemed to belong constantly to the B-lymphocytic line. The secretion and excretion by these cells of an abnormal IgA (devoid of light chains), which was revealed by immunoelectrophorectic study of the patients' sera, was the main biochemical abnormality of the disease. This disease presents several problems: 1) its relationship with other intestinal lymphomas; 2) the nature and the degree of malignancy of the intestinal cellular infiltrates; and 3) its identification as a clinicopathologic entity, with the possibility that infectious and genetic factors are significant in its etiology and pathogenesis.
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PMID:Mediterranean lymphomas with alpha heavy chain monoclonal gammopathy. 82 21

Twenty-seven intestinal lymphoma patients were studied. Abnormal alpha-chain immunoglobulin was detected in the sera of seven of these patients. The alpha-chain disease patients were from the rural areas of Southern Iran. They were of low socio-economic status and their age ranged from 15-44 years. Predominant clinical features were malabsorption, diarrhoea , abdominal pain, vomiting, and weight loss. Infiltration of mucosa of the small intestine with plasma cells and also distortion and flattening of the villi were common histopathologic characteristics of these patients. Involvement of mesenteric lymph nodes with infiltration of tumour cells was observed in a number of cases. Protein studies revealed no significant differences between the serum immunoglobulin levels of these patients and normal values. Immunoelectrophoresis using monospecific antiserum against H-chain of human IgA demonstrated the abnormal precipitin band of alpha-chain disease protein.
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PMID:Alpha-chain disease and its association with intestinal lymphoma. 82 61

Fecal excretion of labeled bile acid (14C-24-cholic acid) was distinctly increased in two infants with protracted diarrhea, whereas four patients with steatorrhea due to pancreatic or mucosal abnormalities and five patients with mild chronic diarrhea had no excess fecal loss of bile acid. The loss of 14C-24-cholic acid in our patients with intractable diarrhea was similar to that observed in four infants who had undergone ileal resection. The ratio of mean 24-hour excretion of bile acid to that of a non-absorbable marker, polyethylene glycol, confirmed the malabsorption of bile acid in the patients with intractable diarrhea or ileal resection. These results differ significantly (p less than 0.05) from excretion ratios obtained in patients with either steatorrhea or chronic diarrhea. The extent of the loss of bile acid was not significantly related to the rate of fecal fat excretion. There was no direct correlation of fecal weight with the rate of bile acid excretion. Ileal function, as further assessed by the Schilling test with exogenous intrinsic factor, was grossly abnormal in both of the patients with intractable diarrhea.
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PMID:Bile acid malabsorption--a consequence of terminal ileal dysfunction in protracted diarrhea of infancy. 83 Aug 89

The clinical significance of sucrose malabsorption in 7 children (5 danish, 2 greenlandic)is discussed. the principal symptom was chronic, watery diarrhea, but meteorismand crying spells were frequent symptoms. the attacks of diarrhea started at thetime sucrose was introduced into the diet. treatment with a diet poor in sucroseled to immediate relief of all symptoms. charts of the growth pattern were drawnup in 5 cases, and they showed a relative increase in weight and length as a result of dietetic treatment, although the values for both length and weight were within the normal range when treatment was commenced.
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PMID:The effect of sucrose malabsorption on the growth pattern in children. 83 62

Examinations of faeces (pH, Clinitest and Clinistix) are liable to contribute to the diagnosis of lactose malabsorption. To confirm the diagnosis the test is to be repeated while Lactase 500 is added to the child's milk. The enzyme does not split the lactase into the two monosaccharides, thus eliminating the malabsorption. The new drug Lactase 500 was used as a diagnostic parameter and for the treatment of lactose malabsorption in 20 infants. The effect on both groups was confirmed as mentioned by foreign authors. In addition to a very simple diagnostic method, which can be performed in the practitioner's office, there are two methods of treating lactose malabsorption: 1. feeding milk free of lactose, 2. feeding milk with an addition of Lactase 500. As in an earlier publication we assumed that about 10 per cent of the population suffers from secondary malabsorption of lactose, it seems advisable to check with the help of the described to simple methods all children with chronic diarrhoea.
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PMID:[Diagnosis and therapy of lactose malabsorption]. 84 87

Diarrhea, an increase in frequency of evacuation and in water content of the stool, is the result of three categories of mechanism--solute malabsorption, secretion of fluid and motility disturbance. Before diarrhea is considered an abnormal condition, any alteration in stool frequency and content must be related to an individual person's normal bowel habit and to norms for the population, but more than three bowel movements or the passage of liquid stools exceeding 300 g daily should, in general, be considered abnormal. A useful way of understanding the mechanism of diarrhea is to become familiar with the normal functions of the bowel in regard to water and electrolyte absorption and motility, and then to relate these functions to solute malabsorption, fluid secretion and motility disturbance.
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PMID:Symposium on diarrhea. 1. Definition and mechanisms of diarrhea. 84 53

Twenty-eight Sioux and 29 Saluteaux Indians from a southern and an isolated northern Manitoban community were screened for lactose malabsorption; 55 were also screened for sucrose tolerance. Sixty percent of the subjects were lactose malabsorbers; the incidence increased with age. Lactase deficiency appeared, on the average, between 8 and 15 years of age. About 45% of the subjects were lactose intolerant. Malabsorbers who did not regularly drink milk had the highest symptom scores. The northern subjects consumed significantly more lactose and sucrose than the southern subjects. Two Sioux children were sucrose malabsorbers. It was hypothesized that the significantly greater sucrose consumption by the Saulteaux subjects were responsible for their markedly higher blood glucose curve following the sucrose tolerance tests. Dietary sucrose increases jejunal sucrase activity and the intestinal transport of glucose and fructose. Three of eight children less than 4 years were lactose malabsorbers; hence, medical personnel treating noninjective diarrhea in Indian children should examine for lactase deficiency. It was recommended that vitamin D fortified milk supplements to Indian school children be continued and that the milk be treated so as to reduce abdominal symptoms in the intolerant individuals.
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PMID:Disaccharide consumption and malabsorption in Canadian Indians. 85 12


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