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

Bile salt pool size and kinetics were evaluated in 8 morbidly obese women before and following jejunoileal bypass. The results indicate that following jejunoileal bypass pool sizes of both chenodeoxycholate and cholate decrease, turnover rates increase, and the rates of bile salt synthesis increase. Influenced by pool size, hepatic synthesis and the degree of malabsorption, the daily bile salt loss may actually decrease in time. Chenodeoxycholate is more efficiently absorbed than cholate in both the preoperative and postoperative states. In spite of greater cholate synthetic capabilities, in this malabsorptive state the chenodeoxycholate pool decreases less than the cholate pool. Although all patients received an identical surgical procedure, the effect on bile salt kinetics and pool sizes varied in these patients. Since some of the postoperative complications may be related to the degree of interference with bile salt metabolism, the individual patient's capacity for increased hepatic synthesis of bile salts and increased reabsorption of bile salts from the remaining small bowel may vary the clinical postoperative course.
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PMID:Bile salt metabolism following jejunoileal bypass for morbid obesity. 83 37

Sixty-three unselected cases of giardiasis, with no evidence of other systemic disease, were screened for evidence of steatorrhoea. No patient had any evidence of protein-energy malnutrition. Seventeen (27%) of the cases had steatorrhoea; three (17-8%) of the 17 patients having steatorrhoea also had D-xylose malabsorption. Vitamin B12 absorption was normal in all. Bacterial culture and qualitative analysis of bile salt in jejunal fluid was carried out in all the 17 cases having steatorrhoea as well as 13 cases with normal absorptive parameters (eight cases of irritable bowel syndrome and five cases of giardia infection) who served as controls. All the patients showing bacterial overgrowth had free bile acids in their duodenal aspirate. Free bile acids could also be detected in jejunal aspirates of five of the seven patients having no bacterial overgrowth. Two control cases of giardia infection with normal small bowel function and sterile duodenal aspirate showed evidence of bile salt deconjugation. The significance of these findings is discussed in relation to the pathogenesis of steatorrhoea in patients with giardiasis. The possible role of giardia in bile salt deconjugation is suggested.
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PMID:Mechanism of malabsorption in giardiasis: a study of bacterial flora and bile salt deconjugation in upper jejunum. 85 75

For evaluation of 14CO2-breath-tests the three most employed tests, namely glycero-14C-tripalmitate-test, 14C-lactose-tolerance-test, and 14C-glycin-cholate-test, were performed in healthy volunteers (n = 69), patients with chronic pancreatitis (n = 18), manifest malassimilation (n = 8), lactase deficiency (n = 15), and patients, in whom a disturbed enterohepatic bile salt circulation was suspected (n = 19). Usefulness of malabsorption tests was limited by many false normal results. Cholylglycin-breath-test on the other hand was sensitive, but clinical significance remained questionable. In our opinion simple performance and lacking discomfort are no sufficient arguments for 14CO2-breath-test.
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PMID:[14CO2 exhalation tests. Diagnostic improvement in gastroenterologic diseases]. 96 89

The fraction of faecal radioactivity excreted after intravenous administration of 14C-labelled cholic acid decreased in most patients with ileopathy and bile salt malabsorption when the dietary daily fat content was reduced from 100 to 40 g. The decreased faecal cholic acid loss might be due to increased bile salt absorption and decreased emptying of the gall-bladder on the fat-reduced diet. A simplified method to determine the corrected 24-hour excretion of radiologically labelled bile salts is described.
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PMID:Effects of a fat-reduced diet on the faecal excretion of radioactivity following administration of 14C-cholic acid and on the duodenal concentration of bile salts in patients with ileal disease. 102 14

Using the glycine-l-14C-cholic acid (14C-GCA) test, bile salt deconjugation and excretion were studied in 26 subjects with morbid exogenous obesity before and at selected intervals after jejuno-ileal bypass. In the preoperative group there was no malabsorption or intestinal bacterial deconjugation of the bile salts. In the immediate postoperative period (with relative sterilization of the bowel) there was only a trace of 14C in the breath, but the fecal 14C was highly elevated, indicating severe malabsorption without bacterial activity. In the 8 to 10 day postoperative period both the breath and fecal 14C content were highly elevated, indicating malabsorption and normal bacterial activity. Five to 8 months postoperatively both the breath and fecal 14C content showed only moderate elevation, indicating adaptation. It is suggested that the 14C-GCA test is useful in evaluating the adequacy of small bowel bypass procedures and also in following the adaptive response after the bypass. A significant increase in the breath and fecal 14C soon after surgery followed by rapid decrease suggests an adequate bypass and unusually fast adaptation. If the increase in the breath and fecal 14C soon after the bypass is only moderate, then that suggests an inadequate bypass.
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PMID:Studies on bile salt deconjugation following small bowel bypass procedures. 113 Aug 57

Malabsorption of rat and alpha-tocopherol was induced in rats by feeding cholestyramine and the effect of Tween 80 and Pluronic F 68 was assessed. Tween 80 did not influence the malabsorption of fat or alpha-tocopherol. Pluronic F68 did not change alpha-tocopherol absorption but did significantly improve fat absorption. The proportion of radioactivity remaining in the liver 5 days after a labelled dose of alpha-tocopherol was increased when Tween 80 or Pluronic F68 was present, perhaps indicating increased absorption via the portal vein. Serum cholesterol levels were not affected by the different diets. The greatly increased excretion of faecal bile salt on dietary cholestyramine was unchanged by the detergents.
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PMID:Effect of non-ionic detergents on the absorption of fat and alpha-tocopherol in the rat. 122 59

The efficacy of cholylsarcosine, a synthetic deconjugation-resistant and nonsecretory conjugated bile acid analog for the treatment of fat malabsorption caused by severe bile acid malabsorption, was assessed in an animal model. In two dogs, the ileum and ileocecal valve were resected, causing severe diarrhea, steatorrhea, bile acid malabsorption, and progressive weight loss. Cholylsarcosine was administered as the water-soluble sodium salt by mixing with the dog food. Various doses were explored as well as varying intakes of dog food. Fat absorption was assessed by gravimetric measurement of fecal fat; a nonabsorbable recovery marker (polyethylene glycol mol wt 4000) was used to correct for incomplete fecal collections. Cholylsarcosine caused a 5- to 30-fold increase in fat absorption but had no significant effect on weight loss or fecal weight. Duodenal content was collected during digestion of a meal via a surgically placed Thomas cannula; the aspirates were dilute, acidic, and had a low bile acid concentration. The bile acid concentration increased modestly when cholylsarcosine was administered, but remained below the critical micellization concentration. The results indicate that oral administration of cholylsarcosine improved dietary fat absorption in a canine model of severe bile acid malabsorption with associated steatorrhea and bile acid deficiency in the proximal small intestine. Studies with this compound in patients with nutritional problems because of steatorrhea and severe bile acid malabsorption appear warranted.
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PMID:Effect of replacement therapy with cholylsarcosine on fat malabsorption associated with severe bile acid malabsorption. Studies in dogs with ileal resection. 1050 37

75SeHCAT scanning was evaluated as a means of detecting bile acid malabsorption in patients with postvagotomy diarrhoea. Seven day 75SeHCAT retention ratios were measured in five patients with unequivocal post-vagotomy diarrhoea. The results were compared with an age matched group of asymptomatic control patients (n = 4) each of whom had previously undergone truncal vagotomy and drainage and a further group of normal volunteers (n = 6). The median 75SeHCAT retention ratios in patients with post-vagotomy diarrhoea was 2% (range 0-9%). In contrast, the median 75SeHCAT retention ratios in asymptomatic controls was 29% (range 26-61%) and 28% (range 19-70%) in normal volunteers. These results demonstrate that there is gross bile salt malabsorption in patients with post-vagotomy diarrhoea and that 75SeHCAT scanning is an effective screening test in these patients.
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PMID:Bile acid malabsorption in patients with post-vagotomy diarrhoea. 148 86

Gallstones are usually present in patients with Crohn's disease involving the distal ileum. This may be due to disturbances of the enterohepatic circulation, with bile salt malabsorption and secondary precipitation of cholesterol in the gallbladder. The article describes three patients who were cholecystectomized for cholelithiasis, and where Crohn's disease was found incidentally during laparotomy.
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PMID:[Crohn disease found incidentally during cholecystectomy. Report of 3 cases with pronounced biliary tract problems]. 186 26

Infection with Giardia lamblia often causes only minor mucosal changes to the small intestine yet frank fat malabsorption may still occur. Some evidence suggests abnormal pancreatic exocrine function in subjects with giardiasis although the mechanism and significance of this is unclear. Studies were conducted in vitro to determine the effect of G. lamblia trophozoites or culture filtrates from the organism on lipolysis of triglyceride by porcine pancreatic lipase. Live trophozoites significantly inhibited lipolysis. The degree of inhibition increased with longer duration of lipase exposure to trophozoites. Total amounts of enzyme inhibited were proportional to enzyme concentration, while the percentage inhibition was greatest at lowest concentration. At a lipase concentration of 1.7 i.u./ml, enzyme activity was reduced by 89.7% compared to controls after incubation for 4 h with trophozoites. The effect was abolished using killed, intact trophozoites. Culture filtrates of G. lamblia did not inhibit lipolysis. Specificity of the effect was suggested by the failure of another flagellate protozoan, Trichomonas vaginalis, to inhibit lipase. In this assay system the inhibition of lipolysis was not dependent on the bile salt concentration present. The impact of this effect in vivo remains to be determined but it may contribute to fat malabsorption in giardiasis.
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PMID:The effect of Giardia lamblia trophozoites on lipolysis in vitro. 194 23


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