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

We examine critically the biochemical methods capable of detecting and monitoring the end-organ disease processes in patients with cystic fibrosis. Although the diagnosis of cystic fibrosis is never justified on the basis of the sweat salt test alone, the original filter-paper technic (Gibson-Cooke, Pediatrics 23:545-549, 1959) for determining Na+ and Cl- concentrations in sweat remains the most discriminating method. We discuss the contributions for neonatal screening of the so-called cystic fibrosis protein, associated decreased enzymic activities in the homo- and heterozygous state, and immunoreactive trypsin. Because evidence of either intestinal malabsorption or a pancreatic lesion must be sought, we review the use and interpretation of some tests of pancreatic dysfunction (meconium albumin, duodenal juice components, serum pancreatic isoamylase, and trypsinogen), both in establishing and in confirming the diagnosis of cystic fibrosis.
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PMID:Cystic fibrosis--its biochemical detection. 635 39

Malabsorption occurs frequently in chronic alcoholics. Alcoholics may malabsorb fat, nitrogen, sodium, water, thiamine, folic acid, vitamin B12 and D-xylose. Malabsorption is due to an abnormal luminal phase of digestion as well as a diffuse functional mucosal abnormality. Malabsorption may, therefore, contribute to clinically significant malnutrition, diarrhoea, folate-deficiency and to abnormalities in tests of xylose and vitamin B12 absorption. Factors producing malabsorption in alcoholics include dietary folic acid and protein deficiency, pancreatic insufficiency, abnormalities of biliary secretions and direct effects of alcohol on the gastrointestinal tract. Many of the absorptive abnormalities are reversed when alcoholics are given a nutritious diet, even with continued intake of alcohol. This highlights the causal role of nutritional deficiencies in the malabsorption of chronic alcoholics.
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PMID:Alcohol, nutrition and malabsorption. 640 71

In order to assess the effectiveness and potential limitations of continuous enteral nutrition (CEN) to correct denutrition related to underlying digestive diseases, 10 nutritional criteria were measured weekly in 92 under-nourished patients fed with CEN for a 3-7 week period. All the patients received a standard non-elemental diet providing a mean daily energy intake of 52.8 kcal/kg BW (36.5 kcal/kg BW by tube feeding and 16.3 kcal/kg BW orally). The influence of preexisting intestinal malabsorption, hypercatabolic status, and post-radiation or inflammatory bowel disease was studied by an a posteriori classification of patients in one of the six following groups: I (no limiting factor), II (malabsorption), III (catabolic disease), IV (catabolic disease and malabsorption), V (colitis), VI (enteritis). During CEN, 8 patients had transient and one had persistent vomiting while 3 developed bronchopneumonia. Gains in body weight, triceps skinfold, midarm muscle circumference, creatinine-height index, urinary sodium and serum transferrin were significant as early as the 2nd week of CEN. Serum albumin and cholesterol, hemoglobin, and total count of lymphocytes were not significantly affected. Sixty-five patients (71 per cent) had an objective nutritional improvement and mean spontaneous oral intake increased from 17.8 to 28.7 kcal/kg BW per day. Significant increase of oral intake and objective nutritional improvement were observed in each group, but a longer period of CEN was necessary to achieve this result in groups II, IV and VI.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Does continuous enteral nutritional deficiencies in digestive system diseases? Results of a longitudinal study of 92 consecutive patients treated for 3 to 7 weeks]. 642 Feb 21

Patients who had undergone proctocolectomy and ileostomy for ulcerative colitis have been studied. One group (contrast group) had undergone resection of only small amounts of terminal ileum (median = 4 cm), the other group of patients (study group) had undergone resection of greater lengths of small bowel (median = 60 cm). Gastric emptying and transit of a standard meal through the small bowel were estimated, whilst the amounts of fat, nitrogen, glucose, sodium and potassium excreted by the ileostomy were simultaneously determined. Significantly greater amounts of fat, nitrogen, sodium, potassium and water were excreted by patients who had undergone resection compared with contrast patients (P less than 0.01). The rate of gastric emptying was not increased in patients who had undergone ileal resection compared with contrast patients but small bowel transit within 4 hours of ingestion of the meal was significantly faster. A significant correlation between transit times and excretion of fat was also noted in patients (P less than 0.02). Thus, quite modest ileal resection in addition to proctocolectomy leads to rapid small bowel transit and marked malabsorption of nutrients as well as water and electrolytes.
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PMID:The effect of resection of the distal ileum on gastric emptying, small bowel transit and absorption after proctocolectomy. 647 55

The main purpose of this work was to study changes in the balance of fluids, electrolytes and blood metabolites in neonatal piglets with severe transmissible gastroenteritis. Six two day old conventional piglets were infected with transmissible gastroenteritis virus while six others were used as normal controls. Blood samples were collected in heparin when the infected piglets were moribund. The following variables were measured: packed red cell volume, total plasma protein and bicarbonate, blood pH, blood urea nitrogen and plasma glucose, creatinine, chloride, inorganic phosphorus, sodium, potassium, magnesium and calcium. Vomiting and diarrhea appeared 12 to 24 hours postinoculation in the infected piglets and they were moribund one or two days later. Before becoming moribund, most of the piglets fell rapidly into a lethargic and comatose state. The most evident changes in their blood variables were an increase in packed cell volume, total protein, blood urea nitrogen, phosphorus and magnesium levels and a decrease in pH and bicarbonate concentration as well as a severe hypoglycemia. The results suggest that severe hypoglycemia coupled with metabolic acidosis and dehydration might be an important factor contributing to the high mortality rates caused by transmissible gastroenteritis in neonatal piglets. The hypoglycemia results from a combination of the inadequate glucose metabolism inherent to neonatal piglets and the acute maldigestion and malabsorption resulting from the diffuse and severe villous atrophy induced by the virus.
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PMID:Hypoglycemia: a factor associated with low survival rate of neonatal piglets infected with transmissible gastroenteritis virus. 647 97

The metabolism of sodium phenytoin (PHT) in the cat was studied by gas-liquid chromatographic analyses of the drug and its metabolites extracted from plasma, urine, and feces during a 5-month course of daily oral administration. Plasma PHT levels of 15-18 micrograms/ml were observed. Urine contained 5-(4-hydroxyphenyl)-5-phenylhydantoin, 5-(3,4-dihydroxy-1,5-cyclohexadien-1-yl)-5-phenylhydantoin, 1-deoxy-1-(5,5-diphenylhydantoin-3-yl)-beta-D-glucopyranuronate, and unmetabolized PHT. Large quantities of PHT (32-63% of the daily dose) were observed in feces. We suggest that gastrointestinal malabsorption, extensive N-glucuronidation, and limited hydroxylation determine the fate of orally administered PHT in the cat. This is not the case in humans.
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PMID:Phenytoin metabolism in the cat after long-term oral administration. 647 7

Intracellular Ca++ is known to influence Na+ flux in luminal membranes. Abnormally elevated Ca++ levels in some cells is believed to be the primary pathophysiologic defect in cystic fibrosis (CF). This in turn is thought to alter Na+ transport which accounts for certain clinical manifestations of this disease. Two Na+-dependent intestinal transport mechanisms have been reported to be suppressed or missing in CF. To examine whether alterations in cell Ca++ may account for these findings, studies were performed to examine the influence of Ca++ on Na+-solute co-transport across intestinal luminal membranes. Purified brush border membrane vesicles prepared from rat small bowel were preincubated in either Ca++-free buffer or buffer containing 2.5 mM CaCl2. Ca++ loaded vesicles showed marked inhibition of Na+ co-transport of taurocholic acid, taurochenodeoxycholic acid, glucose and valine when compared to controls. The uptake of Na+ was also significantly reduced by intravesicular Ca++. These data demonstrate that intravesicular Ca++ inhibits Na+-coupled solute transport as well as Na+ influx across intestinal brush border membranes. These data suggest that intracellular Ca++ may suppress Na+-dependent solute absorption in the intestine. Results presented here further support the theory that elevated intracellular Ca++ may account for intestinal malabsorption and other altered transport phenomena reported in CF.
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PMID:Inhibition of Na+-coupled solute transport by calcium in brush border membrane vesicles. 648 64

The pathogenesis of diarrhea caused by rotavirus infection was studied in miniature swine piglets. The animals were inoculated orally with 2 X 10(7) plaque-forming units of porcine rotavirus (OSU strain). During the height of diarrhea, intestinal function was investigated by in vivo perfusion of a 30-cm segment of proximal jejunum and a 30-cm segment of distal ileum. Absorption of Na+ and water decreased and 3-O-methylglucose transport was markedly reduced, P less than 0.01 compared to control animals. Mucosal lactase and sucrase levels were depressed in both the jejunum and ileum, P less than 0.001. Na+,K+-ATPase activity was significantly depressed only in the ileum, P less than 0.001. These changes were associated with a marked reduction in villous height, suggesting that the diarrhea could be an osmotic diarrhea due to nutrient (carbohydrate) malabsorption. Fresh stool samples were obtained and analyzed immediately for NA+,K+, osmolarity, glucose, and lactose; the osmotic gap was also determined. Stool osmolarity continually increased from 248 +/- 20 mosm/liter prior to inoculation to 348 +/- 20 mosm/liter at 75 +/- 1 hr postinoculation (P less than 0.005); the majority of the fecal osmotic gap could be accounted for by the amount of lactose present in the stools. Stool sodium increased from 34 +/- 6 mM prior to inoculation to a maximum of 65 +/- 4 mM at 53 +/- 1 hr postinoculation, P less than 0.001. There was no significant change in potassium concentration.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Pathogenesis of rotavirus-induced diarrhea. Preliminary studies in miniature swine piglet. 648 82

As the plasma membrane of the cell, the intestinal epithelium ensures the selective functions of the entry and exit of nutriments or metabolites. These functions are controlled genetically by structural genes and eventually by regulatory genes which direct the expression of the former. The influence of some essential nutriments also plays a role. These aspects are illustrated for microorganisms. Selective, congenital intestinal malabsorptions, which are hereditary, occur in humans; their study leads to a better understanding of the genetic and nutritional control of transport mechanisms. Known anomalies of the intestinal transport of basic amino acids have been studied by showing the probable relationships with selective reabsorption deficiencies in the renale tubule and possible disorders of the urea cycle. Amino acid transport through the intestinal epithelium may be under a dual genetic control i.e. at the brush border (co-transport with sodium) as well as at the basal-lateral membrane (diffusion). It is emphasized that small peptides must be present in dietary solutions of enteral origin for amino acid absorption to be optimal. Selective malabsorption of glucose and galactose due to loss of the co-transport systems of glucose-sodium and galactose-sodium at the brush border is discussed. A comparison is made with anomalies of glucose reabsorption in the renal tubule. The digestive consequences (watery diarrhea) of the absence of sodium co-transports has been underlined. A generalization is proposed.
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PMID:[Systems of membrane transport, genetics and nutrition; the example of congenital anomalies of intestinal transport in children]. 651 13

Intestinal malabsorption was studied in 51 cases (46 patients) with radiological and/or operative evidence of small bowel radiation injury. At the time of the study, 23 patients had not been operated on (MED patients), and 28 had undergone previous small-intestinal by-pass or resection (BP/R patients). Fecal analysis data (n = 51), and results of alpha-1-antitrypsin clearance (n = 24), and of D-xylose (n = 37), folic acid (n = 20) and Schilling (n = 27) absorption tests were compared to the extent and severity of small-intestinal damage assessed radiologically and/or operatively. Mean fecal weight was 311 g/24 h in MED patients and 1,190 g/24 h in BP/R patients. Sixty-five, 43, 86, and 82 p. 100 of MED patients, and 93, 77, 93, and 85 p. 100 of BP/R patients, respectively presented increased fecal weight, sodium, lipid, and nitrogen. In MED patients, there was a significant relationship between the extent and severity of small-intestinal damage and fecal weight, lipid, and nitrogen. In BP/R patients, fecal data were related to those calculated from the site and the extent of the intestinal resection. Fecal losses tended to be more abundant when the residual intestine was severely damaged. Alpha-1-antitrypsin clearance (mean 37 ml/24 h) was increased in 8 out of 9 MED patients and in 11 out of 15 BP/R patients. Its value was not related to the extent and severity of small-intestinal damage.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Chronic radiation enteritis. I. Intestinal malabsorption. Anatomo-functional correlates]. 661 73


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