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

Various forms of malabsorption may be differntiated by quantitiative determination of fats, nitrogen and lactic acid in feces. Increased excretion of lactic acid may also be caused by bacterial degradation of intestinal mucus.
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PMID:[Malabsorption]. 125 19

The diagnosis of pancreatic disease is difficult. The first step is clinical suspicion, based on the symptoms and signs. If pancreatic disease is suspected, investigation is necessary to prove this diagnosis. Investigation aims to answer two questions: a) is there pancreatic disease and b) if so, what type? The first question may be answered by demonstrating abnormal pancreatic function, using pancreatic function tests, whereas the second is answered by using techniques to demonstrate structural (anatomical) abnormalities of the pancreas. a) The methods to establish abnormal pancreatic function consist of 1. tests to demonstrate abnormal digestive capability, 2. tests to study pancreatic exocrine secretion, and 3. tests to study endocrine secretion. The tests of group 1 are: chemical fat balance study before and during enzyme replacement therapy, faecal nitrogen balance study, and the demonstration of either the malabsorption of vitamins A, D and K or the sequelae of their malabsorption (low serum calcium, high alkaline phosphatase, prolonged prothrombin time, etc.). Abnormal vitamin B12 absorption also may be present. 2. The tests designed to study pancreatic exocrine secretion are determination of the presence or absence of proteolytic enzymes in the stool, the secretion test, the pancreozymin stimulation test and the Lundh test. The serum amylase and lipase values are of little help in assessment of pancreatic function. 3. The tests to study endocrine function are the glucose tolerances test (which frequently gives abnormal results in pancreatic disease), and radioimmunoassays for insulin and gastrointestinal hormones (which may be increased in patients with functioning tumours of the islet cells). b) The techniques used to establish structural abnormalities of the pancreas are: duodenal cytology (during secretin tests), radiological techniques (abdominal survey films, barium meal, hypotonic duodenography, roentgenography of the biliary tract, barium enema, and angiography,) gastroscopy, duodensocopy, endoscopy and retrograde pancreatography, echography, scan and laparotomy. The relative value of these tests is discussed.
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PMID:Diagnosis of chronic pancreatic disease. 127 46

Crohn's disease involves a great risk of malnutrition. Malabsorption, bacterial contamination, frequent abdominal surgery, meal-related pain, protein loss through the damaged mucosa contribute to creating nutritional problems. Malnutrition can worsen the outcome, both in medical and surgical patients, and deteriorate an often already altered immune response. Weight loss, low levels of blood protein, electrolytes, micronutrients and vitamins are usually related to the extension of the mucosal damage. Nutritional assessment can be difficult due to oedema and bleeding, who interfere with both clinical and laboratory evaluation. The exact amount of nitrogen, lipids, minerals stool loss can be useful. It is widely accepted the use of nutritional support in Crohn's disease, but many Authors do not agree concerning the route (enteral or parenteral) and the kind of nutrient to be used. Still controversial is the role of nutrition: just support or real therapy? Most recent hypothesis concerning the pathogenesis of Crohn's disease indicate food and/or bacterial antigens as involved in determining the pathology. The "bowel rest", considered for many years as a fasting period necessarily supported by parenteral nutrition, can also be obtained by the temporarily reduction or stop in presenting those antigens to the bowel mucosa. This new concept can be achieved not only by parenteral nutrition, but with an enteral elemental diet as well. The elemental diet contains all nutrients in the simplest way and thus succeeds in lowering or eliminating the antigenic power. The reported results seem to indicate an equivalence of enteral and parenteral nutrition; anyway enteral is advisable when feasible, being more physiological and less expensive and involving a lower risk of serious complications.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Possibilities and limitations of nutritional support in Crohn disease]. 129 38

Patients with cystic fibrosis (CF) often exhibit malabsorption despite the use of supplemental pancreatic enzymes. Unabsorbed carbohydrates and amino acids can serve as substrates for large intestine anaerobic fermentation, thus increasing excretion of short-chain fatty acids (SCFA) in the feces. Nine patients with CF on regular pancreatic enzyme supplementations in the age range of 5-11 years and one older patient were studied. Three-day stool samples were collected, as were 72-h food records. Stools were analyzed for gross energy, total nitrogen, fat content, and SCFA concentration. A significant difference was found between CF and normal controls in total caloric excretion due to fat malabsorption. No significant difference was found between CF and normal controls in protein or SCFA excretion. Fat excretion as percentage of fat intake was significantly increased in CF patients: 35.3 +/- 10.2% versus 8.0 +/- 3.0%, respectively. These data suggest that carbohydrate supplementation could be more widely used to increase caloric intake in CF patients without causing secondary osmotic diarrhea.
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PMID:Short-chain fatty acid absorption in patients with cystic fibrosis. 140 62

To evaluate the impact of early pancreatic insufficiency on growth and nutritional status in cystic fibrosis, we studied 49 infants identified by a newborn screening program. Pancreatic insufficiency, determined by increased 72-hour fecal fat excretion, was present in 59% (23/39) of infants at diagnosis (7.0 +/- 0.8 weeks; mean +/- SEM). Before initiation of pancreatic enzyme replacement, growth and nutritional status of pancreatic-insufficient (n = 16) and pancreatic-sufficient (n = 13) infants were compared. Pancreatic-insufficient infants gained less weight from birth to diagnosis (13.4 +/- 3.4 vs 22.3 +/- 4.0 gm/day; p = 0.05), had decreased triceps skin-fold thicknesses (4.5 +/- 0.3 vs 6.1 +/- 0.4 mm; p less than 0.005), and had lower blood urea nitrogen (3.07 +/- 0.42 vs 4.62 +/- 0.65 mg/dl; p = 0.02) and albumin (2.99 +/- 0.14 vs 3.54 +/- 0.14 gm/dl; p less than 0.01) levels despite higher gross calorie (154 +/- 8 vs 116 +/- 13 kcal/kg per day; p less than 0.01) and protein intakes (2.81 +/- 0.21 vs 2.14 +/- 0.33 gm/kg per day; p = 0.03). Fecal nitrogen loss was correlated with fat loss (r = 0.79; p less than 0.001). Fat malabsorption was present in 79% (30/38) and 92% (33/36) of infants tested at 6 months and 12 months of age, respectively, indicating that pancreatic insufficiency persists and increases in frequency throughout infancy. We conclude that pancreatic insufficiency is prevalent in young infants with cystic fibrosis and has a significant impact on growth and nutrition.
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PMID:Pancreatic insufficiency, growth, and nutrition in infants identified by newborn screening as having cystic fibrosis. 155 90

The objectives of the study were to determine whether the follicular (F; days 6-11) and luteal (L; days 16-21) phases of the menstrual cycle were associated with changes in starch malabsorption, stool bulking, stool mucinase, and beta-glucuronidase activities in 10 women (24.1 +/- 0.7 years old) eating a standardized low-fibre diet. Starch malabsorption, measured by breath hydrogen excretion after a breakfast of pureed chickpea (days 10 and 20) versus 10 g lactulose (days 11 and 21), decreased from 9.7 +/- 1.8 g/50 g starch ingested (F) to 6.6 +/- 1.8 g/50 g starch ingested (L) (P less than 0.05). Stool wet weight decreased from 84.5 +/- 10.1 g/day (F) to 52.2 +/- 5.8 g/day (L) (P less than 0.002). Stool dry weight decreased from 20.2 +/- 1.9 g/day (F) to 14.2 +/- 1.1 g/day (L) (P less than 0.006). Stool nitrogen excretion decreased from 1.81 +/- 0.19 g/day (F) to 0.82 +/- 0.06 g/day (L) (P less than 0.006). Stool mucinase and beta-glucuronidase activities were unaffected by the menstrual cycle. These results indicate that women eating low-fibre Western diets may be more prone to constipation during the luteal phase of the menstrual cycle.
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PMID:Starch malabsorption and stool excretion are influenced by the menstrual cycle in women consuming low-fibre Western diets. 166 73

The present experiment was set up to study the effect of Virginiamycin, a nutritional growth promoting antibiotic, on the digestive physiology using precaecal cannulated pigs. The semipurified diet used provided 21% protein and 60% of nitrogen free extract (NFE), 2/3 as starch and 1/3 as lactose. Due the older age of the pigs, the lactose induced some degree of malabsorption as precaecal flow rate of digesta was markedly higher (3.2 kg/d) compared with published data obtained with purified diets without lactose. This was also reflected in the rather low ileal digestibility of the nutrients (%): dry matter 68.6, protein 79.6, fat 78.4 and NFE 75.0. Virginiamycin markedly lowered flow rate (2.2 kg/d) and significantly improved apparent precaecal digestibilities (%): dry matter 74.0, protein 81.4, fat 81.9 and NFE 78.7. The faecal apparent digestibility was comparable with published data. There were no treatment differences indicating that precaecal digestibilities are much more sensitive then faecal ones. In order to explain the differences obtained the mean retention time in the upper intestine was measured. Although significant differences were noted (control: 5 h, Virginiamycin: 6 h) a direct cause-effect relationship was not evident. Also the activity of selected pancreatic enzymes in ileal contents was compared. There were no consistent differences between the two treatments, except for a lower lipase activity during Virginiamycin treatment.
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PMID:Influence of virginiamycin on the digestive physiology in precaecal re-entrant cannulated pigs. 171 96

In this review paper the main properties of elemental, semi-elemental and polymeric diets utilized in enteral nutrition are compared. The theoretical value of elemental diets (they do not require digestion) is upset by their effects on secretion. Semi-elemental diets are not hyperosmolar and are easily absorbed. Polymeric formulas acan be given in almost all indications of enteral nutrition, and in view of the high cost of elemental and semi-elemental diets, the latter should be reserved to elective indications, notably antigenic arrest of the digestive tract and major nitrogen malabsorption.
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PMID:[Elemental, semi-elemental, polymeric diets. Choice, indications, rational use]. 190 76

While the rate of malnutrition is relatively modest in alcoholic patients without alcoholic liver disease, the rate of malnutrition is virtually 100% in patients with alcoholic hepatitis and/or alcoholic cirrhosis. The reasons for malnutrition in the alcoholic hepatitis patient include various factors such as anorexia, poor diet, malabsorption, and altered metabolic state. When the patient is hospitalized, the malnutrition frequently worsens because of fasting for tests, continued anorexia, and complications such as gastrointestinal bleeding. Patients with severe acute hepatitis appear to be both hypermetabolic and hypercatabolic, whereas data are much more conflicting concerning patients with more stable liver disease. Most studies suggest that patients with alcoholic liver disease require at least 60 g of protein per day to maintain positive nitrogen balance. Consistent alterations in plasma amino acid profiles occur in alcoholic liver disease, and specialized nutritional formulations have been devised to correct this amino acid profile with the intent of improving overall nutritional status, hepatic encephalopathy, and mortality. The effects of nutritional support (including use of specialized products) on outcome, on acute hepatic encephalopathy, and on chronic or latent portal systemic encephalopathy are reviewed.
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PMID:Nutrition and alcoholic liver disease. 190 86

The effect of dietary-induced niacin deficiency on intestinal absorption of fat and nitrogen was studied in 18 rats through the metabolic balance technique. When compared with de control group (n = 9) the niacin deficient rats (n = 9) showed higher fecal fat and nitrogen output. The former was diarrhea-dependent and the later diarrhea independent processes. It is suggested that niacin deficiency might induced an early impairment in the intestinal protein absorption followed by diarrhea which would account lately for the fat malabsorption.
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PMID:[Fecal excretion of fats and nitrogen in rats with niacin deficiency]. 209 84


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