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

The biliary and pancreatic secretions have been determined in patients given pelvic or para-aortic irradiation, with a dose of 50 Gy in the former group and between 36 and 40 Gy in the latter. A test meal containing polyethylene glycol (PEG) as reference substance was used. Each sample of the duodenal content was assayed for volume, PEG content, amylase and trypsin activity, pH and biliary secretion. No significant modifications of biliary and pancreatic secretions were demonstrated after irradiation, suggesting that these functions are not involved in the pathogenesis of the malabsorption radiation syndrome.
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PMID:Biliary and pancreatic secretions in abdominal irradiation. 4 Mar 99

The concentration in serum of cathodal trypsinogen has been studied in certain clinical and experimental situations. The concentration correlated with pancreatic amylase activity. Low levels were found in patients with malabsorption due to exocrine pancreatic insufficiency. The concentration rose after endoscopic retrograde cholangiopancreatographic examinations (ERCP). After ERCP, however, no trypsin was detected complexed with protease inhibitors, as is generally found in acute pancreatitis. The trypsinogen concentration in serum also rose in renal failure indicating a renal elimination route for the endogenous trypsinogen.
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PMID:Studies on the turnover of endogenous cathodal trypsinogen in man. 10 10

Physiological bases of digestion and absorption of carbohydrates are reviewed, as a preliminary step, in order to draw a general scheme of its patholophysiology. Clasification of different types of carbohydrate malabsorption is presented. Various exploration methods are discussed in terms of autors' own experiences. Relationship between a sugar screening test, faecal lactic acid contents and a simplified lactose tolerance test, is described in detail. Systematic diagnoses of these diseases are established. Different clinical pictures are reviewed. It is not yet well defined if a starch malabsorption can be caused by either a primary or secondary duodenal amylase deficiency. The clinical forms of congenital sucrose-isomaltose intolerance may be more attenuated than its classical form; incertain cases, secondary sucrose intolerance may also be present due to mucosa anatomic lesions. Maltose malabsorption has no clinical implications. As compared to other alpha-glycosidades, the trehalase activity has been not more affected by not using trehalose in feeding. Primary congenital lactase deficiency is not frequent, whereas secondary forms as much more usual and appear, in primary malabsorption syndromes and in the coeliac disease, very often along with clinical tolerance to lactose. In Spain, lactose nonabsorbers in 16.5% for adults 11.2% for adolescents and 18.3% for children, meaning, that it is being favored by environmental factors in the latter. The unspecified sugar malabsorption during the child's first year is still the most frequent cause of carbohydrate intolerance in children and, although certain progress has been achieved in its diagnosis and therapy, its pathogenic mechanism is not satisfactorily known yet.
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PMID:[Malabsorption of carbohydrates in children (author's transl)]. 23 44

Agarose gel electrophoresis (at pH 8.6) was used for qualitative determination of pancreatic enzymes in duodenal juice. The various enzymes were identified by staining techniques with specific chromogenic substrates, by quantitative determination of enzymes in eluates of gel slices, and by immunoelectrophoresis. The various protein bands corresponded to the following enzymes (from the anode to the cathode): chymotrypsin, trypsin, carboxypeptidase A, chymotrypsin, amylase (around the slit), lipase, elastase, and trypsin. The method was applied to a study of exocrine pancreatic function in 10 adults and 83 children suspected of having malabsorption. The duodenal juice, also analyzed for trypsin and amylase content, was collected in fasting condition and after a test meal of water. In patients with normal pancreatic function, all the enzyme bands were present and easy to recognize. In 87 patients carboxypeptidase A was present as two bands in 68 (80%), anodal trypsin as two bands in 39 (45%), and cathodal trypsin as two bands in 85 (97%). Electrophoresis of duodenal juice gave as much information from the fasting sample as after the test meal. Six children with pancreatic insufficiency (cystic fibrosis and Shwachmar's syndrome) had no or only faintly stained enzyme bands and a strongly stained albumin-containing band most anodally. The method is simple, rapid, and useful in routine work. The combination of this qualitative test with a quantitative one (e.g. trypsin determination) provides good information about exocrine pancreatic function.
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PMID:Agarose gel electrophoresis of duodenal juice in normal condition and in children with malabsorption. 43 37

Pancreozymin-secretin test (PS test) and intestinal absorption tests were performed in 21 patients with chronic calcific pancreatitis and 32 patients with chronic noncalcific pancreatitis to evaluate exocrine functions of the pancreas. And the following results were confirmed. (1) Fecal fat excretion increased in 33% of chronic pancreatitis (47% of calcific pancreatitis and 25% of noncalcific pancreatitis). Serum carotene leves showed significantly low levels in 44% of chronic pancreatitis (67% of calcific pancreatitis and 27% of noncalcific pancreatitis). (2) D-xylose tolerance test was abnormally low in only 6% of chronic pancreatitis, but Schilling test was evaluated abnormally low in 29% of chronic pancreatitis (50% of calcific pancreatitis and 11% of noncalcific pancreatitis). (3) Fecal fat excretion increased in cases of severe exocrine insufficiency of the pancreas with decreased amylase output and decreased maximum bicarbonate concentration in PS test. (4) Correlation of fecal fat excretion to maximum bicarbonate concentration was statistically significant, but those to amylase output or volume of pancreatic juice were not significant. (5) Antacid drugs combined with pancreatic extracts seems to be indispensable in the treatment of chronic pancreatitis as far as malabsorption in chronic pancreatitis is concerned.
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PMID:Studies on intestinal malabsorption in chronic pancreatitis. 101 98

Dietary carbohydrates, which constitute a most important source of equine nutrition, are digested and absorbed by a series of complex processes principally in the small intestine, beginning with intraluminal starch hydrolysis by the action of pancreatic amylase. The continuous secretion of a copious volume of pancreatic juice, low in enzyme activity, presumably releases sufficient oligosaccharides for further hydrolysis at the intestinal cell surface by brush border enzymes. Active carrier mediated mechanisms then transport the final hexose products across the intestinal cell for uptake in the hepatic portal system. Brush border disaccharidase activities in the equine small intestine are of the same order of magnitude, and have a similar distribution pattern, to those reported in omnivorous and carnivorous species. The disaccharidase development patterns are characteristic and reflect the ability of the horse to digest the major nutrient sources adequately at various stages of life. The efficiency of the mucosal disaccharidases and the monosaccharide transport systems in the equine small intestine have been established by a series of oral disaccharide and monosaccharide tolerance tests. Horses older than three years of age are unable to hydrolyse lactose, but young and adult horses are fully capable of rapidly hydrolysing sucrose and maltose loads. Several tests have clinical application for assessing small intestinal dysfunction in the investigation of diarrhoea and malabsorption. The deficient digestion or absorption of carbohydrate, whether primary or secondary, can almost always be localized to a defect in the enzymic or transport capacity of the small intestinal surface cell. The continued ingestion of lactose could be detrimental in severely diarrhoeic foals.
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PMID:Carbohydrate digestion and absorption in the equine small intestine. 110 Aug 25

1. Intestinal brush border enzymes have heterogeneous rates of turnover, the largest proteins having the fastest turnover. Since the membrane faces the intestinal lumen, the effects of pancreatic factors were examined in mediating this turnover. Surgical subtotal pancreatectomy was used as an experimental model to study the turnover of brush border proteins in the absence of most pancreatic secretions. 2. Subtotal (95%) pancreatectomy of rats was found to cause elevations by about 50% of total activity and specific activities of certain brush border enzymes (maltase, sucrase, lactase), but not of others (alkaline phosphatase, trehalase). Rats were judged to be functionally deficient in pancreatic proteolytic enzymes (a) by demonstration of vitamin B-12 malabsorption, which was corrected by trypsin, and (b) by the finding of only about 20% of proteolytic activity appearing in the lumen after a test meal when compared to control. 3. To measure protein turnover in vivo the method of double labelling was used, where [3H]- and [14C]valine were administered intraduodenally in sequence 10 h apart. With this technique, a high 3H/14C ratio is correlated with rapid turnover. Proteins with apparent molecular weights of about 200 000-270 000 were found to turn over more rapidly than smaller proteins. 3H/14C ranged from 4.7 to 6.2 in animals without pancreatic insufficiency. In the face of decreased pancreatic proteolysis, the 3H/14C ratio was 2.3-3.1, similar to that of proteins with a slow half life. 4. Estimates of relative synthetic rates of large brush border proteins were lower than normal in pancreatectomized animals, but were constant over the period of the labelling experiment. The high enzyme levels in the face of lower synthetic rates confirms that, at the new steady rate, degradation rates must be slower for large brush border proteins in pancreatic insufficiency. 5. In vitro, using purified brush borders, unfractionated pancreatic enzymes were found to remove sucrase, maltase and lactase, but not alkaline phosphatase and trehalase. The enzyme most potent in this respect was the pancreatic protease, elastase. Non-proteolytic enzymes (amylase, lipase, phospholipase A) were inactive in removing enzyme from the brush border. The addition of elastase to pancreatectomized animals in vivo restored the rapid turnover rate of large brush border proteins. 6. A model is thus proposed for the normal catabolism of some large intestinal brush border proteins. It is suggested that the surface of intestinal absorptive cells is being constantly remodelled, and that certain surface enzymes are in part removed from the membrane by the action of pancreatic proteases. A possible special role for elastase is suggested.
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PMID:The possible role of pancreatic proteases in the turnover of intestinal brush border proteins. 114 88

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

Pancreatic function was evaluated in 16 22-56-year-olds with ulcerative colitis. The diagnosis was verified by coprogram, glycemic curves, blood and urine amylase, ultrasound and endoscopic findings. A basal level of pancreatic polypeptide (PP) was measured in blood serum under glucose tolerance test (50 g) using radioimmunoassay. Intracavitary pH-metry provided data on pH in the upper gastrointestinal tract. The results were processed according to Student's t-criterion. The evidence demonstrated pancreatic involvement with secretory and endocrine insufficiency leading to homeostatic derangement of enteral medium and malabsorption in ulcerative colitis. The addition of pancreatic enzymes and antacids is advisable as pathogenetically valid.
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PMID:[The role of pancreatic polypeptide in the pathogenesis of malabsorption in ulcerative colitis]. 187 44

The influence of hydrolysis on the assimilation rate of important nutritional carbohydrates was studied in healthy subjects and patients with intestinal diseases, mainly by means of 13CO2 breath test techniques. All substrates were "naturally enriched" with carbon-13. The studies showed that hydrolysis is the rate limiting step for the assimilation of lactose, starch and even maltose, but not for the assimilation of sucrose. The degree of gelatinisation and the degree of side-branching of starch molecules were two important parameters, influencing starch hydrolysis in normal subjects. Addition of wheat bran had no influence on the digestion rate of starch. A comparative study between normal subjects and patients with pancreatic disease, showed that starch digestion may be impaired in patients with pancreatic disease. However, this occurs only if amylase output is extremely low. The effect of lactase deficiency on lactose absorption was studied in patients with a history suggestive of lactase deficiency. For this purpose a lactose 13CO2 and H2 breath test were compared with lactase activity in a jejunal biopsy. The results showed that the relation between lactase activity in the biopsy and lactose assimilation takes the form of a saturation curve. The 13CO2 breath test was found to be a reliable test for the diagnosis of lactase deficiency. Finally, the effect of acarbose on starch digestion was studied in normal subjects, ileostomy patients, and a fecal incubation system. These experiments showed that acarbose may induce an important degree of starch malabsorption. If administered in high doses, the effect is not only related to inhibition of brush border enzymes, but also to the inhibition of alpha-amylase.
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PMID:Georges Brohee Prize 1988-1989. Assimilation of nutritional carbohydrates: influence of hydrolysis. 205 48


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