Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0024523 (malabsorption)
 7,319 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In 16 consecutive patients with systemic mastocytosis, we prospectively evaluated a variety of gastrointestinal functions and examined how they relate to the occurrence of gastrointestinal symptoms. Nine patients had either a duodenal ulcer or duodenitis. Hypersecretion of gastric acid was present in 6 patients, and in these patients the mean basal acid output was 20.7 +/- 4.1 mEq/h (range 14-39 mEq/h). Impaired small intestinal absorption occurred in 5 patients, although this was usually mild. The mean fractional emptying rate of liquids for all patients (14.7% +/- 2.3% per minute) did not differ from that for controls (10.7% +/- 0.6% per minute). Mean mouth-to-cecum transit time measured by breath hydrogen testing was the same among patients (87.7 +/- 6.7 min) and controls (86.7 +/- 8.0 min). Plasma histamine concentrations were increased in all patients (mean 1886 pg/ml, range 480-7450) and correlated with the basal acid output (r = 0.64, p less than 0.02) but not maximal acid output or the presence or absence of pain or diarrhea. Mean fasting plasma concentrations of motilin, substance P, and neurotensin from 6 patients did not differ significantly from controls, whereas gastrin and vasoactive intestinal peptide were significantly less than in controls (p less than 0.01). Gastrointestinal symptoms, consisting of abdominal pain or diarrhea, occurred in 80% of patients. Abdominal pain classified as dyspeptic was usually associated with acid-peptic disease of the duodenum and hypersecretion of gastric acid, whereas abdominal pain of a nondyspeptic character was not. Only in those cases of diarrhea consisting of greater than 200 g stool/day was gastric acid hypersecretion frequently found. Neither fecal urgency nor nondyspeptic pain could be accounted for by alterations of gastrointestinal transit. These results demonstrate that gastrointestinal symptoms, peptic disease, and mild malabsorption are much more common than described previously in patients with systemic mastocytosis. Furthermore, the results provide no evidence for the contention that altered gastrointestinal transit is involved in the pathogenesis of these symptoms.
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PMID:Gastrointestinal dysfunction in systemic mastocytosis. A prospective study. 339 14

Pancreatic enzyme substitution may principally be used in few indications, whereof most of them are only relative. The most obvious indication is malabsorption in chronic pancreatic insufficiency, which is always associated with an advanced form of the disease. Only when the exocrine secretory capacity of the pancreas is 2% or less does the patient exhibit diarrhea with a daily excretion of 25 g of fat or more on a normal diet. There are also strong indications that pain can be controlled in some patients with chronic pancreatitis, and the mechanism for this can be given a plausible explanation. As the pancreatic enzymes (with a few interesting exceptions) are resistant to the hydrochloric acid of the stomach, the galenic preparation must be given attention, and means of reducing the amount of acid in the stomach can be considered. However, the patients' compliance is just as important; the dosage must be individualized. The enzyme preparations must be easy to handle and all patients on regular medication must be given full information of the goals of the therapy. The socio-psychological side effects of the chronic disease should also be considered to get an optimal effect of the enzyme substitution in pancreatic disease.
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PMID:Enzyme substitution in pancreatic disease. 365 Jan 82

Using breath hydrogen analysis after an oral lactose load (2 g/kg; maximum 50 g), we investigated the prevalence of lactose malabsorption in 61 healthy Italian children aged 6-13 years. We also examined the relationship between symptoms and small bowel transit time and the degree of sugar malabsorption. Three of 61 subjects produced no H2 after both lactose and lactulose load and thus were eliminated at the outset. Lactose malabsorption was defined as excretion of greater than 20 ppm H2. Lactose intolerance was classified as mild (colicky pain, flatulence, abdominal distension, borborygmi) or severe (diarrhea). The frequency of lactose malabsorption in the children aged 6-8 years (group I) was 25%; in the children aged 8-11 years (group II), it was 35%, and in the children aged 11-13 years (group III) 56%. The differences in frequency between the first and the third groups were significant (p = 0.05). Three of 20 (15%) in group I, two of 20 (10%) in group II, and three of 18 (17%) in group III were classified not only as lactose malabsorbing, but also as lactose intolerant, with symptoms during and after the test. We found no difference in the small bowel transit times or in the quantities of malabsorbed lactose in symptomatic and asymptomatic malabsorbing subjects. Other factors that may play a role in symptom production are discussed.
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PMID:Lactose absorption and malabsorption in healthy Italian children: do the quantity of malabsorbed sugar and the small bowel transit time play roles in symptom production? 398 73

Chronic peptic ulcer disease is not generally considered to cause failure to thrive. We are reporting a 9-year-old child who suffered from chronic recurrent abdominal pain and failure to thrive. Investigation revealed that the child also had bacterial overgrowth and evidence of malabsorption. These findings were considered to be due to chronic peptic ulcer disease which caused intermittent small bowel obstruction and gastric outlet obstruction. Successful treatment of the ulcer alone resulted in catch-up growth and an end to the chronic recurrent pain. Recurrent abdominal pain when associated with atypical features or failure to thrive should be adequately investigated. Although rare, chronic peptic ulcer disease with its sequelae should be considered in the differential diagnosis of failure to thrive.
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PMID:Failure to thrive associated with chronic ulcer disease in a 9-year-old boy. 401 3

A total of 107 patients with chronic pancreatitis from the London area seen between 1968 and 1973 have been reviewed; they comprised 30 with calcific pancreatitis and 77 with chronic or chronic relapsing pancreatitis without calcification. The commonest clinical features were pain, diabetes, malabsorption, and peptic ulcer. Alcohol was a probable aetiology in nearly half the cases, a different finding from those of previous surveys and possibly associated with the increased consumption of alcohol in England in the last 20 years.
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PMID:Chronic pancreatitis in England: a changing picture? 482 Oct 40

Based on the results of treatment of a personal series of 13 cases of pseudocyst of the pancreas, between 1974 and the present day, it is suggested that the choice of therapy should be surgical. An internal shunt is preferred for pseudocysts as a result of acute pancreatitis or injury, whereas a wider cysto-wirsung jejunostomy is recommended for cysts developing during the course of chronic pancreatitis. These proposals follow analysis of immediate and long-term (mean: 51 months) follow-up, on the basis of mortality, morbidity, pain symptoms, malabsorption and postoperative diabetes.
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PMID:[Treatment of pancreatic pseudocysts]. 647 70

Intestinal pseudo-obstruction (IP) is an uncommon disorder of gut motility which must be differentiated from mechanical intestinal obstruction. We have seen 11 such patients over the last 5 years. Characteristic symptoms, shared by mechanical obstruction, include abdominal distention and pain, nausea, and vomiting. Radiologic studies reveal dilated loops of bowel with air fluid levels. In most patients a major differentiating feature from obstruction may be the presence of diarrhea rather than obstipation. Steatorrhea is secondary to an overgrowth of anaerobic bacteria in the motionless dilated loops of bowel. IP has been associated with various disorders: in our series two patients had scleroderma, one multiple small bowel diverticula, one systemic amyloidosis, one celiac disease, and one spinal cord injury; in only two patients was the disorder considered "idiopathic." Three patients had previously undergone a jejuno--ileal bypass for morbid obesity. During the acute episode, the patients were treated symptomatically with decompression by nasogastric or rectal tube with fluid and electrolyte replacement. Malabsorption treated with broad spectrum antibiotics reversing the steatorrhea but not episodes of pseudo-obstruction. Magnesium deficiency was present in seven patients and its correction resulted in amelioration of the symptom complex. In two patients episodes of pseudo-obstruction were markedly reduced by metoclopramide which was not effective in two others.
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PMID:Chronic intestinal pseudo-obstruction. 679 59

Duodenal diverticula are not uncommon. Uncomplicated diverticula require no treatment. In the period 1970 to 1980, 104 patients with symptoms presented at the Vancouver General Hospital and the Swedish Hospital in Seattle. Of these, 26% presented with pain and 24% with anemia. Malabsorption and benign tumours were noted infrequently. Fifteen patients were treated surgically for pain, perforation, hemorrhage, tumour, blind loop syndrome and obstruction of the duodenum, biliary tract or pancreatic duct. Two patients died. The second part of the duodenum was involved in 82% and the third part in 10%. Anatomical variations are common in the area of the ampulla; these should be anticipated before operation. Surgical procedures in the area may be technically demanding and associated with high mortality and morbidity. The choice of procedure depends on the urgency and nature of the complication of the diverticulum. Endoscopic retrograde cholangiopancreatography can play a role in evaluating the possible significance of the diverticulum and the anatomy of the area. In some cases endoscopic sphincterotomy may be possible. In some situations diverticulectomy is contraindicated.
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PMID:Management of duodenal diverticula. 680 32

In 138 mongrel dogs given renal transplants, 10 developed postoperative intussusceptions. The sites were jejunojejunal (seven), ileo-ileal (two) and ileocolic (one). In 30 puppies given intrasplenic autografts of dispersed pancreatic fragments after total pancreatectomy, five developed jejunojejunal intussusceptions. Presenting signs included vomiting, failure to eat, periodic attacks of pain, straining with the passage of bloodstained mucous, dehydration, weight loss, abdominal wall rigidity and an abdominal mass. The majority of dogs presented within the first seven days following transplantation, occasionally as late as the third week. Early operative intervention was essential to save the dogs and at laparotomy eight of nine intussusceptions were successfully reduced manually; one small bowel resection was performed for irreducibility. Recurrence was not observed in this series but reoperation in the puppies was invariably fatal. Factors contributing to the development of intussusception in the puppies included round worm infestation, recent dietary change following weaning, malabsorption and diarrhoea due to pancreatic insufficiency following pancreatectomy and respiratory infections suggesting an infective origin for the intussusceptions.
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PMID:Canine intestinal intussusception following renal and pancreatic transplantation. 701 80

In order to evaluate the role of lactose malabsorption in children with recurrent abdominal pain, we performed a prospective controlled double-blinded study in 40 children with RAP of at least three months' duration. Children were studied for lactose malabsorption by breath hydrogen determinations after ingestion of lactose (2 gm/kg of body weight; maximum 50 gm). Lactose malabsorbers were retested with 12.5 gm lactose; lactose absorbers were retested with lactose for ability to produce hydrogen. All children underwent a dietary trial which included two lactose elimination periods. Although 12 children (30%) were lactose malabsorbers, only three malabsorbed part of the smaller, more physiologic, lactose load. Improvement rates of lactose malabsorbers and absorbers during lactose elimination were not significantly different as judged by their physicians and as determined by a 50% or more decrease in pain frequency. These results suggest that lactose malabsorption is of little importance in children with RAP.
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PMID:Lactose malabsorption in recurrent abdominal pain of childhood. 705 18


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