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The Nursing Clinics of North America Sep 2018Malabsorption syndrome refers to the small intestines' inability to absorb certain nutrients and fluids. There are several common associated disorders, which may present... (Review)
Review
Malabsorption syndrome refers to the small intestines' inability to absorb certain nutrients and fluids. There are several common associated disorders, which may present with subtle and/or overt symptoms. With subtle symptoms, it is difficult to determine the cause, making diagnosis difficult or even inaccurate. Malabsorption can originate from an immune response, an inflammatory process, or alternation of the small intestines by surgical methods. This article reviews common malabsorption disease processes of the small bowel and the resulting pathophysiology. Diagnostic studies, treatment, and prognosis of various conditions within the malabsorption disease state are discussed.
Topics: Celiac Disease; Humans; Malabsorption Syndromes; Short Bowel Syndrome
PubMed: 30100002
DOI: 10.1016/j.cnur.2018.05.001 -
Gut Nov 2019Lactose is the main source of calories in milk, an essential nutriedigestion, patients with visceral hypersensitivity nt in infancy and a key part of the diet in... (Review)
Review
Lactose is the main source of calories in milk, an essential nutriedigestion, patients with visceral hypersensitivity nt in infancy and a key part of the diet in populations that maintain the ability to digest this disaccharide in adulthood. Lactase deficiency (LD) is the failure to express the enzyme that hydrolyses lactose into galactose and glucose in the small intestine. The genetic mechanism of lactase persistence in adult Caucasians is mediated by a single C→T nucleotide polymorphism at the LCTbo -13'910 locus on chromosome-2. Lactose malabsorption (LM) refers to any cause of failure to digest and/or absorb lactose in the small intestine. This includes primary genetic and also secondary LD due to infection or other conditions that affect the mucosal integrity of the small bowel. Lactose intolerance (LI) is defined as the onset of abdominal symptoms such as abdominal pain, bloating and diarrhoea after lactose ingestion by an individual with LM. The likelihood of LI depends on the lactose dose, lactase expression and the intestinal microbiome. Independent of lactose digestion, patients with visceral hypersensitivity associated with anxiety or the Irritable Bowel Syndrome (IBS) are at increased risk of the condition. Diagnostic investigations available to diagnose LM and LI include genetic, endoscopic and physiological tests. The association between self-reported LI, objective findings and clinical outcome of dietary intervention is variable. Treatment of LI can include low-lactose diet, lactase supplementation and, potentially, colonic adaptation by prebiotics. The clinical outcome of these treatments is modest, because lactose is just one of a number of poorly absorbed carbohydrates which can cause symptoms by similar mechanisms.
Topics: Humans; Lactose Intolerance; Malabsorption Syndromes
PubMed: 31427404
DOI: 10.1136/gutjnl-2019-318404 -
Nutrients Apr 2021Numerous disorders can alter the physiological mechanisms that guarantee proper digestion and absorption of nutrients (macro- and micronutrients), leading to a wide... (Review)
Review
Numerous disorders can alter the physiological mechanisms that guarantee proper digestion and absorption of nutrients (macro- and micronutrients), leading to a wide variety of symptoms and nutritional consequences. Malabsorption can be caused by many diseases of the small intestine, as well as by diseases of the pancreas, liver, biliary tract, and stomach. This article provides an overview of pathophysiologic mechanisms that lead to symptoms or complications of maldigestion (defined as the defective intraluminal hydrolysis of nutrients) or malabsorption (defined as defective mucosal absorption), as well as its clinical consequences, including both gastrointestinal symptoms and extraintestinal manifestations and/or laboratory abnormalities. The normal uptake of nutrients, vitamins, and minerals by the gastrointestinal tract (GI) requires several steps, each of which can be compromised in disease. This article will first describe the mechanisms that lead to poor assimilation of nutrients, and secondly discuss the symptoms and nutritional consequences of each specific disorder. The clinician must be aware that many malabsorptive disorders are manifested by subtle disorders, even without gastrointestinal symptoms (for example, anemia, osteoporosis, or infertility in celiac disease), so the index of suspicion must be high to recognize the underlying diseases in time.
Topics: Anemia; Humans; Infertility; Intestinal Absorption; Intestinal Mucosa; Intestine, Large; Intestine, Small; Malabsorption Syndromes; Nutrients; Osteoporosis
PubMed: 33920345
DOI: 10.3390/nu13041254 -
Clinics in Perinatology Jun 2022Feeding intolerance is ubiquitous in neonatal intensive care units with as many signs and symptoms as possible diagnoses. Optimizing nutrition is paramount in both... (Review)
Review
Feeding intolerance is ubiquitous in neonatal intensive care units with as many signs and symptoms as possible diagnoses. Optimizing nutrition is paramount in both preterm and term infants. Determining the cause of feeding intolerance and adjusting nutrition interventions is an important part of the daily care of newborns. This review discusses the role of malabsorption and food intolerance as possible causes of nutrition difficulties in the newborn.
Topics: Food Hypersensitivity; Food Intolerance; Humans; Infant; Infant, Newborn; Malabsorption Syndromes
PubMed: 35659102
DOI: 10.1016/j.clp.2022.02.015 -
Gastroenterology Jun 1966
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The British Journal of Nutrition Feb 2022This review intends to act as an overview of fructose malabsorption (FM) and its role in the aetiology of diseases including, but not limited to, irritable bowel... (Review)
Review
This review intends to act as an overview of fructose malabsorption (FM) and its role in the aetiology of diseases including, but not limited to, irritable bowel syndrome (IBS) and infantile colic and the relationship between fructose absorption and the propagation of some cancers. IBS results in a variety of symptoms including stomach pains, cramps and bloating. Patients can be categorised into two groups, depending on whether the patients’ experiences either constipation (IBS-C) or diarrhoea (IBS-D). FM has been proposed as a potential cause of IBS-D and other diseases, such as infantile colic. However, our knowledge of FM is limited by our understanding of the biochemistry related to the absorption of fructose in the small intestine and FM’s relationship with small intestinal bacterial overgrowth. It is important to consider the dietary effects on FM and most importantly, the quantity of excess free fructose consumed. The diagnosis of FM is difficult and often requires indirect means that may result in false positives. Current treatments of FM include dietary intervention, such as low fermentable oligo-, di-, monosaccharides and polyols diets and enzymatic treatments, such as the use of xylose isomerase. More research is needed to accurately diagnose and effectively treat FM. This review is designed with the goal of providing a detailed outline of the issues regarding the causes, diagnosis and treatment of FM.
Topics: Breath Tests; Colic; Fructose; Humans; Irritable Bowel Syndrome; Malabsorption Syndromes
PubMed: 33818329
DOI: 10.1017/S0007114521001215 -
Digestion Aug 1998Malabsorption syndromes commonly result from a pathological interference of the normal digestive process. There have been major advances in the last 4 years. The purpose... (Review)
Review
BACKGROUND/AIMS
Malabsorption syndromes commonly result from a pathological interference of the normal digestive process. There have been major advances in the last 4 years. The purpose of this review is to highlight in the form of a brief summary the most outstanding information available.
METHODS
The review was performed based on a medical literature search using MEDLINE (1993-1997), bibliographic reviews of book chapters and review articles. As a consequence of the extensive information incorporated in the period and the limited scope of this review, the review will focus in three aspects: (1) an overview on some clinical aspects of malabsorption; (2) diseases in which predominates the disturbed mucosal phase of the digestive process, and (3) providing information on diagnostic testing regarding malabsorption.
RESULTS
Major advances on celiac disease, Whipple's disease, giardiasis, tropical sprue, malabsorption of oligo- and disaccharides, vitamin B12 and bile salts are discussed. New aspects on diagnostic procedures for malabsorption are also presented.
CONCLUSION
Although major advances have given a great support to the investigation of malabsorption, yet the syndrome remains a major diagnostic dilemma. Based on the limited availability of most diagnostic tests, a simple and practical diagnostic algorithm is presented.
Topics: Bile Acids and Salts; Diagnosis, Differential; Humans; Intestinal Absorption; Intestinal Mucosa; Malabsorption Syndromes; Monosaccharides; Oligosaccharides; Retrospective Studies
PubMed: 9705537
DOI: 10.1159/000007529 -
The Journal of the Association of... Apr 2022Among the causes of malabsorption, tropical sprue is one of the leading cause.Several reports indicating that celiac disease, now being recognised more frequently.
UNLABELLED
Among the causes of malabsorption, tropical sprue is one of the leading cause.Several reports indicating that celiac disease, now being recognised more frequently.
MATERIAL
94 patients, aged more than 12 years, presenting with Chronic diarrhoea and malabsorption syndrome were analyzed by clinical presentation, endoscopic and histopathological examination.The spectrum of disease in these patients and features differentiating celiac disease and tropical sprue are reported here.
OBSERVATION
Most common cause was Celiac Disease (65%), followed by Tropical Sprue (21%), common variable immunodeficiency (2%), lymphangiectasia (1%), idiopathic (3%). Patients with celiac disease were younger,having anemia, scalloping of folds,moderate or severe villous atrophy, crypt hyperplasia, diffuse epithelial damage. Patients with tropical sprue were older and more often normal duodenal epithelium.
CONCLUSION
Malabsorption, a disease which is often missed and not recognised by clinicians. A meticulous search for diagnosis is required.
Topics: Celiac Disease; Duodenum; Humans; India; Malabsorption Syndromes; Sprue, Tropical
PubMed: 35443489
DOI: No ID Found -
Clinical Gastroenterology and... Aug 2018
Review
Topics: Carbohydrate Metabolism; Disease Management; Humans; Malabsorption Syndromes
PubMed: 29425782
DOI: 10.1016/j.cgh.2018.01.048 -
Current Gastroenterology Reports Oct 2000Malabsorption syndromes often present diagnostic dilemmas to even the most experienced clinicians. Several malabsorption screening tests are available, but d-xylose... (Review)
Review
Malabsorption syndromes often present diagnostic dilemmas to even the most experienced clinicians. Several malabsorption screening tests are available, but d-xylose testing is our initial screening method of choice. Recent innovations such as serum assays for antibodies associated with celiac sprue are improving the work-up of patients with suspected malabsorption. In addition, physicians are applying technological advances in imaging to determine the underlying pathologies responsible for the occurrence of malabsorption and maldigestion. Breath testing remains a controversial modality in the work-up of patients with malabsorption. Tubeless tests of pancreatic function are also the subject of debate due to a lack of sensitivity for diagnosing mild to moderate chronic pancreatic insufficiency. This review identifies and provides critical analysis of new developments in the field of malabsorption testing. The authors also provide a clinical algorithm for diagnosing malabsorption.
Topics: Algorithms; Breath Tests; Cholangiopancreatography, Endoscopic Retrograde; Diagnosis, Differential; Humans; Malabsorption Syndromes; Medical History Taking; Reagent Kits, Diagnostic; Xylose
PubMed: 10998664
DOI: 10.1007/s11894-000-0036-6