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

Malabsorption (M) is characterized by absorption defect of one or several nutriments in small bowel. Its clinical expression is rarely obvious and biological signs are: anaemia, low serum protein, albumin and lipid rates, low serum calcium, phosphorus and potassium level, and hypoprothrombinaemia. But only 4 simple and reliable tests are needed for diagnosis: i. e.: daily faecal fat amount measurement, daily faecal nitrogen excretion, the xylose test and the Schilling's test. This syndrome is related to many conditions which can be divided into 2 groups with and without intestinal abnormalities. The relationships between M and skin diseases belong to 4 types (J. Marks and S. Shuster): 1) M is responsible for the cutaneous signs, 2) M is caused by a skin disease, 3) both M and skin disease are the result of a same cause, 4) M and skin disease are associated in an indirect way. Only the two first types are dealt with in this report. Skin manifestations occur as a complication in 10 p. 100 to 20 p. 100 of cases of M. They are mostly polymorphous or non-specific, as they are related to multiple vitamin or essential amino acid deficiencies and heal with the treatment of M. The main conditions encountered are diffuse pigmentation, acquired ichthyosis, follicular keratosis, nail brittleness and hair loss. Mucous membrane lesions, purpura and eczematoid or psoriasis-like dermatitis have also been described. More uncommon are clubbing of fingers, finger print abnormalities, kwashiorkor or acrodermatitis enteropathica-like eruptions. The dermatogenic enteropathy, i. e. a M syndrome due to a skin disease, occurs as a result of widespread involvement of the body for instance in psoriasis or eczema; its clinical expression is rarely obvious, the histological record of gut biopsy usually normal and the results of biological tests often dissociated, but steatorrhoea is frequently found. The pathogenesis of the condition is still unknown but its importance is related to the extent of the skin disease and it only improves with the treatment of the latter. All these features and others are discussed in the report with a comprehensive review of the literature.
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PMID:[Cutaneous manifestations of malabsorption diseases (author's transl)]. 38 Apr 45

What will be our GI approach to a child with FTT syndrome? Detailed history and physical examination will give us the clue and often the probable diagnosis. Several laboratory tests are helpful in establishing the fact that there is malabsorption. Among them are a complete blood count with smear, quantitative stool fat excretion, serum protein and chemistry screen panel, prothrombin time, and oral tolerance and absorption--i.e., of glucose, iron, vitamin A, and xylose. Specialized procedures may be used to nail down the diagnosis: radiology, biopsy, duodenal intubation, etc. These should never be employed as routine screening tests, however. In outlining a comprehensive and successful therapy, the attending physician will find it helpful to consider the particular pathophysiologic mechanisms of a specific disease. Exact diagnosis makes the therapy both rational and effective.
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PMID:Pathophysiology of failure to thrive in gastrointestinal disorders. 74 Apr 23

The total quantity of endogenous plus exogenous protein digested and absorbed in the normal gastrointestinal tract in man is in excess of 150 mg per day. Total fecal nitrogen indicates net losses of less than 10% per day in health. Malabsorption and maldigestion both contribute to a decrease in assimilation of exogenous and endogenous proteins. Abnormal serum protein losses across the gastrointestinal tract may be totally recovered if the leak is small and proximal in the intestine. Specific defects in amino acid absorption are often compensated by intact peptide absorption.
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PMID:[Intestinal protein assimilation and losses in man (author's transl)]. 89 19

Calcium absorption and endogenous loss of calcium were measured in a group of patients with Crohn's disease, using a simultaneous metabolic balance and calcium isotope regimen. Calcium malabsorption resulting in negative calcium balance was found in only 4 of 31 patients with Crohn's disease. No elevation of endogenous fecal calcium or total secreted intestinal calcium was observed in 10 patients studied, regardless of the level of net or true calcium absorption. Correlation between calcium balance and serum protein loss was observed, but no association was noted with intestinal fat excretion, d-xylose absorption, bacterial colonization of the jejunum, or glucocorticosteroid therapy. The results indicate that in this group of patients with Crohn's disease involving different areas of the intestine, calcium malabsorption occurred infrequently and that the levels of calcium excretion correlated best with enteric protein loss.
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PMID:Calcium absorption in Crohn's disease. 93 86

Duodenal-jejunal bacterial overgrowth is increasingly recognized in old age but its clinical significance is poorly defined. In this study, 16 elderly subjects were selected on the basis of an abnormal lactulose breath hydrogen test from a series of 27 in whom there was some reason to suspect malabsorption. In 12 of these 16 cases, pentagastrin tests showed normal gastric acid secretion and in 12 cases the small bowel was radiologically normal. Nutritional assessment, anthropometric measurements, culture of small-bowel aspirates, 14C-triolein breath tests and blood xylose tests were performed before and after 4 to 6 months of cyclical antibiotic therapy. Initially all patients except two showed evidence of malabsorption. After antibiotic treatment alone, 13 patients gained in weight and body fat. There were significant rises in the mean levels of haemoglobin, serum protein and calcium. Blood xylose test levels increased in 14 cases, reaching normal in all except one, whereas 14C-triolein excretion also increased in 14 and reached normal in 12 out of 16 cases. The breath hydrogen test reverted to normal in all cases and bacterial overgrowth was eliminated in 10 out of 11. The mouth-to-caecum transit time was prolonged initially (mean 190 min) and was unaffected by therapy (mean 196 min). Malabsorption and undernutrition are significant features of small-bowel overgrowth in the elderly and can be specifically corrected by antibiotic treatment. The clinical effect can be equally severe in elderly patients with or without an anatomical defect of the small bowel.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Small-bowel bacterial overgrowth in elderly people: clinical significance and response to treatment. 155 53

In this study designed to investigate the nutritional state induced by biliopancreatic bypass in the rat, the pancreatico-biliary secretions were diverted via the duodenum and jejunum into the distal ileum, the remaining intestine being directly anastomosed to the stomach after antrectomy. Bypassed animals lost weight: it was only 56 percent of that of controls after 36 days and death by cachexia resulted within two months of the procedure. The reduced food intake (16 percent less than control) at the 36th postoperative day cannot by itself explain the weight loss, since pair-fed rat weights did not differ statistically from controls at 36 days. Protein-energy malabsorption occurred: drops in serum protein concentration (25 percent less than control), triglycerides (40 percent less) and total cholesterol (28 percent less) were recorded from the 12th postoperative day on. Biliopancreatic bypass may be an adequate procedure of treatment for morbid obesity simultaneously aggravated by metabolic disorders.
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PMID:Malnutrition and body weight loss after biliopancreatic bypass in the rat. 201 Feb 58

We present here two cases of reversible hypoproteinemia which could have occurred as an adverse effect of chronic lithium administration. In the present cases, protein losing a renal dysfunction, liver dysfunction and malabsorption syndrome were not observed, and the relationship between their dietary volume and serum protein levels was poor. The mechanism of hypoproteinemia in these cases was not identified from previously obtained data. We suggested that this type of hypoproteinemia might be a new adverse effect of lithium.
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PMID:Hypoproteinemia related with chronic lithium therapy in two patients. 211 66

A patient with acquired immunodeficiency syndrome (AIDS) who required aggressive nutritional intervention via home parenteral nutrition therapy is described, and nutritional status, etiology and therapeutic management of AIDS-associated malnutrition, role of nutrition support, and factors for consideration in using parenteral nutrition in AIDS patients are discussed. Parenteral nutrition therapy was initiated in a 30-year-old AIDS patient with Kaposi's sarcoma lesions of the gastrointestinal tract because of rapid weight loss, low serum protein levels, and malnutrition. He had previously undergone a small-bowel resection and a jejunojejunostomy, and radiation and antineoplastic-drug therapy was planned. During parenteral nutrition therapy, the patient demonstrated increased physical strength and was able to care for himself during most of the time spent at home or in a long-term-care facility. Aggressive measures, including parenteral nutrition therapy, were discontinued 11 days before the patient's death. Complications of therapy included one episode of sepsis and a tear in the external catheter tubing. Malabsorption and diarrhea mainly caused by gastrointestinal disease, reduced food intake because of oral and esophageal infections, adverse effects from medication, and depression are factors that can contribute to AIDS-associated malnutrition. Also, hypermetabolism resulting from infections and fevers may contribute to malnutrition in AIDS. The extent to which this malnutrition affects the underlying immune dysfunction occurring in the syndrome and the response to other more direct drug therapies in AIDS is not known. Available methods for nutritional intervention are based on clinical experience and anecdotal reports. Because of gastrointestinal disease, an oral diet, supplements, and enteral tube feedings may not meet nutritional goals for an AIDS patient.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Parenteral nutrition in the management of gastrointestinal Kaposi's sarcoma in a patient with AIDS. 313 64

The nutritional conditions and absorptive capacity of nine infants with short bowel syndrome were investigated during a long follow-up period from one and half years to 14 years and 7 months. The length of the residual small intestine ranged between 13 and 90cm. The nine infants had normal meals at home and did not suffer from persistent diarrhea. Most of the infants were thin. Nutritional conditions, for example, serum protein, triglycerides, vitamins, trace elements and plasma amino acids, were kept relatively well, and there were no symptoms of deficiency. The results of D-xylose absorption test had gradually improved but the absorptive capacity of sugars and amino acids observed by potential differences were within the normal limits or slightly subnormal except one infant. This indicated that the absorptive capacity of sugars and amino acids per a given area of the residual small intestine did not increase. From our examination the critical length of intestine might be in the neighborhood of 50cm. The infants left with less than 50cm of small intestine seem to have grown up normally but malabsorption of fat, sugars and bile acids have continued for many years.
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PMID:[The evaluation of the nutritional condition and the absorptive capacity in long-term follow-up of infants with short bowel syndrome]. 403 27

The effect of intestinal malabsorption on the oral bioavailability of prednisolone has been studied in six patients with celiac disease and in six patients with malabsorption of various etiologies, five of whom had undergone gut resections. The serum protein-binding of prednisolone was measured in five patients with celiac disease and hypoalbuminemia and in eight healthy controls. Compared with the controls, patients with celiac disease had a 22% lower peak serum prednisolone concentration (p less than 0.05) and a 16% smaller area under the time-concentration curve of total prednisolone (NS). The proportion of free prednisolone was 79% greater in patients with celiac disease (p less than 0.01), and the area under the time-concentration curve of free, biologically active prednisolone 53% larger (p less than 0.05). There were no significant differences in peak prednisolone concentration or area under the time-concentration curve between the controls and the other patients with malabsorption, who all had normal serum albumin concentrations. These results indicate that the absorption of prednisolone in patients with malabsorption is normal and that the apparently reduced bioavailability in celiac disease patients is more likely to be due to an increased volume of distribution secondary to hypoalbuminemia and reduced protein-binding.
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PMID:Bioavailability of prednisolone in patients with intestinal malabsorption: the importance of measuring serum protein-binding. 666 30


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