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

In the light of 350 cases of E.P.N., prevention of complications rests upon: 1. supply of hydroelectrolytics and proteinoenergetics at reduced dosage, initially, and then adapted to the anabolic stimulation, taking into consideration the correlations which exist between calories, nitrogen, calcium, phosphorus, zinc and vitamins, particularly those of the B-complex; 2. the necessity to achieve a progressive withdrawal through the supply of enteral elementary substances which will permit a modulated new induction of the digestive enzymatic secretory activities. The indications for such a highly technical program may emanate in the course of serious malabsorption with severe denutrition within the framework of inflammatory and vascular enteropathies and in the presence of certain metabolic disturbances, either congenital or acquired.
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PMID:[Metabolic problems and indications for exclusive and prolonged parenteral feeding in children]. 12 55

A jejuno-ileal bypass operation which excluded about 85% of the small intestine was conducted in two groups of rats to evaluate the effects of oral feeding versus total parental nutrition (TPN). One group received food orally while another group received TPN. Two other groups of nutritive control animals underwent laparotomy and suture markings on the intestine. Animals were sacrificed two weeks after the shunt or sham operation. The liver, kidneys, pancreas and spleen were weighed. The wet and dry weights and the villus height of small intestinal segments were also determined. The shunt-operated TPN rats showed a body weight gain of 28% over the initial body weight while the orally fed animals showed an increase of 3.2%. The TPN controls had a negative nitrogen balance only on the day of the sham operation, whereas the TPN shunt-operated animals changed to positive nitrogen balance on the second postoperative day. The wet weights of the liver, kidneys and spleen were significantly higher in TPN animals. The functioning region of the small intestine in the shunt-operated animals was hypertrophic in both the orally fed and the TPN animals, but there were greater quantitative changes in the orally fed animals. The experiments demonstrated the beneficial effect in rats of TPN over oral nutrition for the treatment of surgically induced malabsorption. The studies also showed that the small intestine is capable of developing compensatory mucosal action without intraluminal nutritive content, although the presence of food in the lumen appears to stimulate morphological changes to a greater extent after massive small bowel resection.
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PMID:Total parenteral nutrition after small intestinal bypass operation in rats. 13 36

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

There are many factors which are responsible for the high incidence of cachexia in human neoplasia. In this review, those considered to be of major importance are discussed. Nutritional disturbances, such as anorexia and malabsorption, are common and nutritional repletion may be beneficial to certain patients. Raised metabolic rate and energy expenditure are also encountered. Tumour cells may act as a nitrogen trap or energy sink, but the significance of these mechanisms in man is questionable. Ectopic hormone production by tumours is well established and a number of tumour-derived substances have been described which interfere with the intermediary metabolism of the host. The significance of these various substances also remains uncertain. Most experimental studies of cancer cachexia have utilized transplantable animal tumour models which bear a poor resemblance to the clinical condition. Development of more suitable models with human tumour xenografts might allow a quicker and better understanding of the aetiologies of human cancer-induced cachexia.
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PMID:Cancer cachexia in man: a review. 39 80

Forty newborns bearing several gastrointestinal conditions (congenital malformations, intestinal bypass, postinflammatory obstruction, malabsorption and enteritis) were treated with long-term integral parenteral nutrition. A solution made up of synthetic aminoacids, emulsion of lipids, glucose, electrolytes, vitamins, plasma and whole blood was perfused through a catheter introduced into central or peripheral veins. Temporal glucosuria and anemia were observed in some cases. In all but three cases urinary alpha amino nitrogen was normal. In some infected patients leucocytosis or leucopenia was found. After treatment, all patients showed adequate nutritional conditions, manifested by increase in body weight and healing of damaged tissues.
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PMID:[Integral intravenous feeding in pediatric surgery]. 40 74

Intestinal perfusion studies performed in man have suggested that amino acid nitrogen may be absorbed more rapidly from peptides than free amino acids. The aim of the present study was to compare the effects of the oral administration of peptides and free amino acids. Two isonitrogenous liquid test meals, one containing 50 g of a partial enzymic hydrolysate of fish protein in which approximately 80% of the nitrogen content was present as small peptides (peptide meal), and the other a mixture of free amino acids (amino acid meal) the composition and molar pattern of which simulated that of the peptide meal, were administered on separate occasions to six normal subjects intubated with a triple lumen tube. Both meals contained the reference marker polyethylene glycol. Fractional absorption of amino acid residues one and two hours after ingestion of the two meals was similar at three intestinal locations situated 120, 160, and 200 cm from the mouth of each subject, and at two hours 73.8% and 72.0% of the amino acid residues had been absorbed respectively by the time the contents of the peptide and amino acid meals reached the middle sampling port of the tube. The total sum of individual amino acid increments in plasma was significantly greater 30 minutes (p < 0.025) and one hour (p < 0.05) after ingestion of the peptide than amino acid meals. By three hours the total area under the two plasma curves was similar. Normal human subjects thus appeared to be capable of assimilating orally administered mixtures of peptides and free amino acids with equal efficiency. Secretion of fluid into the lumen of the upper small intestine, assessed by reference to dilution of the polyethylene glycol, was less after ingestion of the peptide meal. In clinical situations characterised by fluid and electrolyte malabsorption consideration might be given to using small peptides rather than free amino acids as the nitrogen source in nutritional diets.
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PMID:Comparison of oral feeding of peptide and amino acid meals to normal human subjects. 44 9

A gas-solid chromatographic system using tandem silica gel and molecular sieve columns is described for the measurement of hydrogen, carbon dioxide, oxygen, and nitrogen in samples of respiratory gases. This system has a detection limit of 2 ppm of hydrogen in a 1 ml sample and can measure 120 ppm H2 and 5% CO2 with relative standard deviations of 1.3% and 1.7%, respectively. Improved sample storage and withdrawal techniques are described that give reproducible values for up to 6 weeks after collection. Finally we show that normalization of breath hydrogen values to an alveolar concentration, using the observed carbon dioxide concentrations, substantially reduces the range and variance of apparent H2 concentrations in human subjects. Normalization eliminates the need for rebreathing or end-expiratory collection techniques and substantially increases the reliability and clinical utility of hydrogen breath measurements in noninvasive tests of carbohydrate malabsorption.
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PMID:Improved gas chromatographic quantitation of breath hydrogen by normalization to respiratory carbon dioxide. 50 Dec 2

Growth arrest and delayed onset of puberty often complicate childhood onset Crohn's disease of the small bowel (granulomatous enteritis). Nutritional deficits arising from inadequate dietary intake, malabsorption, and increased caloric needs may contribute to growth retardation. To assess whether a sustained high caloric and nitrogen intake could reestablish growth, 4 children with extensive Crohn's disease of the small bowel were studied before and after parenteral alimentation which was instituted for symtomatic disease control. Weight gain, positive nitrogen balance, and improved nutritional status were achieved during parenteral alimentation in each patient. In 2 patients weight gain was sustained using oral nutritional supplements, and a substantial increase in linear skeletal growth continued in the ensuing months. One patient entered puberty within 4 months of parenteral alimentation and another had the onset of menarche and the development of secondary sex characteristics 4 months after parenteral alimentation and resection of diseased bowel. Growth may be reestablished in some growth-arrested children if intake is sufficient to establish a sustained positive caloric and nitrogen balance. Nutritional requirements imposed by the demands of growth and active disease and often compounded by the catabolic effects of corticosteroids may be excessive; growth may occur only if these needs are met orally and/or parenterally.
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PMID:Reversal of growth arrest in adolescents with Crohn's disease after parenteral alimentation. 81 57

Very frequently in acute and chronic pancreatitis, the surgical treatment is indispensable. The disease itself is accompanied by metabolic disturbances, protein deficiency, hepatic lesion, by diabetes and malabsorption syndrome. Following the laboratory parameters we were able to perform partial or total hyperalimentation, correction of acid-base dis-equilibrium and to obtain the positive nitrogen balance, and in this way keep the patients in optimal conditions pre- and postoperatively.
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PMID:[Metabolic disorders and current treatment of the surgical patient with pancreatitis]. 85 52

Extensive metabolic studies were conducted in five normal controls and in five study patients after total gastric resection with Roux-en-Y (RY) reconstruction to determine the nutritional consequences of this particular technique of restoring gastrointestinal continuity. Although malabsorption of fat (19.2 +/- 2.2%) and nitrogen (22 +/- 2.5%) demonstrated in the study patients was moderate, it was significantly greater than normal ( less than 0.01). In spite of the demonstrated malabsorption, however, positive nitrogen balances (+ 0.33 +/- 0.18 gm/day) were maintained in the RY patients throughout the investigative period. These observations suggest that malabsorption after RY is infrequently of clinical significance, even in this "worst-case" situation characterized by complete removal of gastric tissue. Malnutrition should occur in only those patients with more limited gastric resections and RY reconstruction who are unable to increase caloric intake to cover losses due to malabsorption. A significant decrease in both trypsin and lipase concentrations and a marked delay in secretion of these enzymes was noted in the RY patients in response to a test meal (p less than 0.01). Malabsorption of fat and nitrogen in RY patients improved after exogenous pancreatic enzymes, but not after administration of tetracycline. Bacterial overgrowth as a cause of postoperative malabsorption may be less important than previously thought. Malabsorption after RY is due primarily to maldigestion brought about by duodenal bypass which, in turn, results in either an absolute or a relative pancreatic enzyme insufficiency.
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PMID:Pathophysiology and significance of malabsorption after Roux-en-Y reconstruction. 87 Oct 13


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