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

The records of 26 patients in one practice who had had a partial gastrectomy were studied to see if a stated policy of follow-up had been successful. The policy aimed to detect by annual blood tests (birthday follow-up) the consequences of malabsorption of iron, folate, vitamin B12, and calcium. Of 198 possible tests (nine for each patient when seen for the first screening), only 87 (44 per cent) were done; 16 (18.2 per cent) were abnormal. At the 39 opportunities for annual follow-up, 71 per cent of the possible tests were done; 11 of the 62 tests (17.5 per cent) were abnormal. The most common abnormality was deficiency of iron (12 tests), followed by folate (four tests), serum B12 (two tests), and serum calcium (two tests). Appropriate action according to the review criteria was taken for 24 out of the 27 abnormalities found. The result of the review was to suggest a modified annual follow-up, with fewer than nine tests per year.
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PMID:An audit of the care of post-gastrectomy patients. 741 20

We have previously reported our efforts to minimize postgastrectomy symptoms in two patients with benign disease who underwent resection of the head of the pancreas and the duodenum. In these cases the pylorus and first portion of the duodenum were preserved during pancreaticoduodenectomy. Our experience has now been extended to encompass 18 patients, eight of whom were available for comprehensive evaluation an average of six months postoperation. These studies have attempted to differentiate malabsorption of pancreatic insufficiency from possible gastrointestinal dysfunction of the new alimentary connection. Pancreatic insufficiency was evaluated by a 72-hour stool collection and radioactive trioctanoate (RATO) test. Gastrointestinal absorption was evaluated by D-xylose excretion and the Schilling test, as well as serum vitamin. A, vitamin B-12, carotene, folate, iron, and total iron binding capacity. Gastrointestinal secretion and motility were assessed by using pyloric fluoroscopy, gastric barium emptying, the Hunt test, and gastric acid analysis. Finally, a questionnaire regarding clinical symptoms of postgastrectomy syndromes and malabsorption was answered. Although every patient exhibited marked pancreatic insufficiency by laboratory tests, 88% described normal formed bowel movements, and weight loss was claimed by only 25%. Other test findings were generally normal. While the follow-up period has been limited to three years, the current data demonstrate that gastrointestinal function subsequent to preservation of the pylorus has not thus far predisposed to postgastrectomy syndromes or marginal ulcers. All of the patients required intensive pancreatic enzyme replacement.
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PMID:Preservation of the pylorus in pancreaticoduodenectomy a follow-up evaluation. 741 28

We report a case of a woman affected by sideropenic anaemia (SA) for about thirty years and never restored with a therapy with iron per os. At the age of 60 years a malabsorption syndrome appears and an adult celiac disease was diagnosed (ACD). The SA was therefore and since the beginning the only symptom of the malabsorption. When SA is resistant to the iron per os therapy, we always should suspect a malabsorption due to CD often olygosymptomatic in the adult patient. We would now recommend, in presence of resistant SA, the weight of jejunum biopsy, as well as his excessive importance, when it shows an apparently not specific finding of mucosa atrophia with chronic phlogosis.
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PMID:[A case of resistant sideropenic anemia. Adult celiac disease]. 756 95

This study describes small bowel push enteroscopy in routine clinical practice, using a purpose designed instrument (Olympus SIF-10). Fifty six patients had a total of 60 procedures over a two and a half year period. The median (range) depth of small intestine intubated was 45 (15-90) cm. Procedure time varied from 10-45 minutes. Most enteroscopies were performed during routine gastroscopy lists. The technique was comparatively easy for experienced endoscopists to learn. Forty two procedures were for diagnostic purposes. Eleven patients had gastrointestinal bleeding where the source was obscure, or where early investigations had suggested a small bowel source: a specific diagnosis was made in 45% of these cases. Of seven iron deficient anaemic patients using non-steroidal anti-inflammatory drugs (NSAIDs), only one had a lesion detected in the upper small bowel. Nine patients had abnormal small bowel barium studies. Small bowel abnormalities were seen in six cases and were definitively diagnostic in three of these; in three patients the barium study appearances were confirmed as artefact. Fifteen patients were investigated for abdominal symptoms suggesting small bowel obstruction or malabsorption: a diagnosis was made in five cases. Fifteen patients underwent enteroscopy for therapeutic purposes, including successful treatment of difficult enteral feeding problems by nasojejunal tubes or by cutaneous endoscopic jejunostomies, polypectomy for Peutz-Jeghers syndrome, and dilatation of strictures. Additionally, bleeding lesions detected in patients during investigation of anaemia were successfully treated at the time by YAG laser or bipolar diathermy. In conclusion, push enteroscopy is a practical and valuable clinical service, which should probably become available on a subregional basis.
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PMID:Diagnostic and therapeutic push type enteroscopy in clinical use. 759 Apr 29

Giardia lamblia, an intestinal parasite of humans and other vertebrates, undergoes surface antigenic variation by modulating the expression of different variant-specific surface proteins (VSP). VSPs are cysteine-rich surface proteins that bind zinc and other heavy metals in vitro. We developed an immunoaffinity chromatographic method to purify a VSP in order to determine its biochemical properties. The sequences of two different proteolytic fragments agreed with the sequence deduced from the cloned gene, and amino-terminal sequence indicated the removal of a 14-residue signal peptide, consistent with the transport of VSP to the cell surface. The protein is not glycosylated and has an isoelectric point of 5.3. X-ray microanalyses indicated that the major metals in Giardia trophozoites, as well as purified VSP, are zinc and iron. The zinc concentration in Giardia cells was found to be 0.43 mM and the iron concentration 0.80 mM when compared with standard samples (zinc) or calculated from a known physical constants (iron). We propose that metal coordination stabilizes VSPs, rendering them resistant to proteolytic attack in the upper small intestine. Moreover, the ability to bind ions by Giardia may play a role in nutritional deficiency and/or malabsorption in heavily infected persons.
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PMID:Purification of a variant-specific surface protein of Giardia lamblia and characterization of its metal-binding properties. 777 37

Weight loss, chronic diarrhea and fat malabsorption are frequent after total gastrectomy. The aim of this work was to study parameters of intestinal absorption and the histology of jejunal mucosa in 26 patients subjected, at least one year ago, to total gastrectomy and without evidences of tumoral relapse. There was a mean weight loss of 9 kg (range 4 to 20) and 46% of patients had intermittent or episodical diarrhea. Hemoglobin was below 12 g/dl in 4 patients, serum albumin was below 3.5 g/dl in 3, serum carotene was below 40 micrograms/dl in 5 and serum iron was below 80 micrograms/dl in 5. Jejunal biopsies were normal and steatocrit was abnormal in all patients. Present findings suggest that fat malabsorption in these patients is intraluminal and due to an unequal mix of pancreatic and biliary secretions, as a consequence of Y en Roux transit reconstruction.
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PMID:[Intestinal malabsorption in patients treated with total gastrectomy]. 808 66

The role of bile salts in intestinal Fe absorption has not previously been defined. We have recently shown that bile salts having cholanic ring 7 alpha-OH and/or 12 alpha-OH groups bind Fe2+ with high affinity at premicellar concentrations and also produce a two-to threefold enhancement in Fe2+ uptake from perfused intestinal segments in vivo. However, the physiological relevance of these observations for Fe2+ absorption was not known. To study this, we examined the effects of a single dose of taurocholate (TC) administered with 59Fe-FeSO4 in reversing iron malabsorption induced by bile duct ligation. Fe absorption from three 0.5-mg doses of 59Fe-FeSO4 was measured from five groups of six adult Sprague-Dawley rats each: group 1, before and after bile duct ligation and subsequent administration of 59Fe-FeSO4 + TC test dose; group 2, before and after bile duct ligation followed by a third dose of Fe alone; group 3, before and after bile duct ligation followed by a third dose of Fe+taurodehydrocholate (TDHC); group 4, sham laparotomy; and group 5, nonoperated controls where Fe absorption was measured from three doses of 59Fe-FeSO4 at the same time intervals as group 1. Absorption was measured, using whole body counting, after achievement of steady-state counts after each Fe dose. Mean percentage absorption from dose 1 (baseline) was 35.33 +/- 4.6% (SE). No significant differences between any groups were noted. In nonoperated controls (group 4), Fe absorption was virtually identical after all three doses. Also, hematocrit did not change in any of the 30 animals.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Evidence that bile salts are important for iron absorption. 814 5

Often anaemia and other haematological changes are unrelated to primary diseases of the erythron but are secondary to gastrointestinal alterations, such as occult or overt blood loss or defective absorption of essential haemopoietic factors. This overview emphasizes, through the description of different pathological conditions, the fundamental role of the gastrointestinal tract in maintaining a normal haematological balance. This role is jeopardized in diseases related to the liver and to the various sections of the alimentary tract from the oesophagus to the rectum. Of primary importance in inducing haematological changes which may be modified by curing the primary condition are essentially the diseases of the small intestine, following malabsorption of iron, folic acid and vitamin B12, such as conditions associated with small intestine bacterial overgrowth, tropical sprue, gluten sensitive enteropathy whipple's disease and various infections with intestinal parasites. Moreover, the Authors briefly survey the other pathological conditions of the alimentary tract often associated with chronic bleeding. In this context of particular relevance are the screening procedures which may reveal the presence of occult bleeding caused by neoplastic diseases. It is important that the clinician be aware of this possibility and of the underlying physiopathological mechanism of the diseases of the alimentary tract, so that appropriate and timely therapeutic measures may be undertaken.
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PMID:Anaemias and other haematological changes due to disease of the alimentary tract. 821 Jun 28

Twenty-six Ascaris-infected children and 21 control children (10 of whom had iron-deficiency anaemia) were subjected to haematological and oral iron absorption tests. The levels of oral iron absorption by the infected children and by the healthy controls were similar, whereas the level of absorption by the children with iron deficiency anaemia was relatively high. It therefore appears that Ascaris infection does not lead to iron malabsorption and iron deficiency anaemia in children.
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PMID:Effects of ascaris infection on iron absorption in children. 831 72

After the development of monophasic combined oral contraceptives (COCs), containing a fixed dose of estrogen and progestogen, biphasic and triphasic COCs were introduced in the 1980s; in these the dose of ethinyl estradiol and progestogen changes during the pill cycle. In the so-called every day pills, the 21 pills of active steroid combination are followed by 7 inactive pills containing starch, iron, or bran. Method failures of OCs are among the lowest ranging from 0.2-1/100 woman-years. User failures can be as high as 6.2/100 women-years. The individual difference in peak plasma levels of estrogens in women taking identical OCs can be 10-fold. Conditions that affect the bioavailability of contraceptive steroids are: 1) drug interaction (vitamin C, drugs that induce liver enzymes, and antibiotics); 2) vomiting; 3) vegetarianism; 4) missing pills; and 5) malabsorption. Metabolic effects of COCs pertain to carbohydrate metabolism, lipid metabolism, hemostasis, and vitamins. Prescribing of COCs involves counseling clients about contraindications to COCs, starting routines, and the pill-free interval, as well as follow-up and monitoring, the problem of missing pills, and selection criteria for OC use. Medical conditions in which COC use requires special consideration are sickle cell disease, trophoblastic disease, HIV disease, gallstones, epilepsy, valvular heart disease, oligomenorrhea/amenorrhea, inflammatory bowel disease, and surgery. Side effects of COCs may include depression, nausea, vomiting, headaches, urinary tract infection, and lower genital tract infections. 6 months after stopping the OC 1% of users become amenorrheic. Many of the common causes of amenorrhea, such as weight loss amenorrhea and polycystic ovarian disease, may be treated with the COC until the couple desires to have a baby. The new progestogens desogestrel, norgestimate, and gestodene are highly selective compared to first and second generation progestogens.
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PMID:Combined oral contraceptives: acceptability and effective use. 832 4


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