Malnutrition in gastrointestinal disease can result from several pathogenetic mechanisms. The resulting clinical and laboratory features of malnutrition vary according to the specific pathogenetic factors involved. Many of the causes of malnutrition in gastroenterology are similar to those found in other acute and chronic diseases. However, certain disorders, specific to gastroenterology, may alter nutritional indices independent of the usual causes of malnutrition. These include small bowel bacterial overgrowth and protein-losing enteropathy. The impact of these disorders on the indexes of nutritional status is discussed. (Journal of Parenteral and Enteral Nutrition 11:126S-129S, 1987)
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References
1.
King CE, Toskes PP: Small intestine bacterial overgrowth. Gastroenterology76:1035-1055, 1979
2.
Donaldson RM Jr: Small bowel bacterial overgrowth. Adv Int Med16:191-212, 1970
Goldstein F. : Mechanisms of malabsorption and malnutrition in the blind loop syndrome. Gastroenterology61:780-784, 1971
5.
Donaldson RM Jr: Malabsorption of 36Co-labeled cyanocobalamin in rats with intestinal diverticula. I. Evaluation of possible mechanisms. Gastroenterology43:271-281, 1962
6.
Donaldson RM Jr, Corrigan H., Natsios G.: Malabsorption of 60Co-labeled cyanocobalamin in rats with intestinal diverticula. II. Studies on contents of the diverticula . Gastroenterology43:282-290, 1962
7.
Tabaqchali S. : The pathophysiological role of small intestinal bacterial flora. Scand J Gastroenterol [Suppl]6:139-163, 1970
8.
Gracey M.: The contaminated small bowel syndrome: Pathogenesis, diagnosis, and treatment . Am J Clin Nutr32:234-243, 1979
9.
Jones EA, Craigie A., Tavill AS: Utilization of urea nitrogen for albumin synthesis in a stagnant loop syndrome . Gut9:466-469, 1968
10.
Yap SH, Hafkenschid JCM, van Tongeren JHM, et al: Rate of synthesis of albumin in relation to serum levels of essential amino acids in patients with bacterial overgrowth in the small bowel . Eur J Clin Invest4:279-284, 1974
11.
Holt LE, Snyderman SE, Norton PM, et al: The plasma aminogram in kwashiorkor. Lancet2:1134-1348, 1963
12.
Jones EA, Smallwood RA, Craigie A., et al: The enterohepatic circulation of urea nitrogen. Gut37:825-836, 1969
13.
Hoffbrand AV , Tabaqchali S., Mollin DL: High serum-folate levels in intestinal blind loop syndrome. Lancet1:1339-1342, 1966
14.
Bernstein LH , Gutstein S., Efron G., et al: Experimental production of elevated serum folate in dogs with intestinal blind loops: Relationship of serum levels to location of the blind loop. Gastroenterology63:815-819, 1972
Waldmann TA , Steinfeld JL, Dutcher TF, et al: The role of the gastrointestinal system in "idiopathic hypoproteinemia." Gastroenterology41:197-207, 1961
17.
Dobbins WI: Electron microscopic study of the intestinal mucosa in intestinal lymphangectasia . Gastroenterology51:1004-1017, 1966
18.
Douglas AP, Weetman AP, Haggith JW: The distribution of enteric loss of 51Cr-labeled lymphocytes in normal subjects and in patients with coeliac disease and other disorders of small intestine . Digestion14:29-35, 1976
19.
Strober W., Wochner RD, Carbone PP, et al: Intestinal lymphangectasia. A protein-losing enteropathy with hypogammaglobulinemia, lymphocytopenia, and impaired homograft rejection. J Clin Invest46:1643-1656, 1967
20.
Dionigi P., Dionigi R., Nazari S., et al: Nutritional and immunological evaluations in cancer patients. Relationship to surgical infection. JPEN4:351-356, 1980
21.
Pekarek RS, Beisel WR: Characterization of the endogenous mediator(s) of serum zinc and iron depression during infection or other stresses. Proc Soc Exp Biol Med138:728-731, 1971
22.
Awai M., Brown EB: Study of the metabolism of I131 labeled human transferrin. J Lab Clin Med61:363-365, 1963
23.
Sitrin MD, Rosenberg IH, Chawla K., et al: Nutritional and metabolic complication in a patient with Crohn's disease and ileal resection. Gastroenterology78:1069-1079, 1980
24.
Blackburn GL , Bistrian BR, Maini BS, et al: Nutritional and metabolic assessment of the hospitalized patients . JPEN1:11-22, 1977
25.
Bistrian BR, Blackburn GL, Vitale J., et al: Prevalence of malnutrition in general medical patients. JAMA235:1567-1570, 1976
26.
Stromberg BV , David RJ, Pharm D., et al: Relationship of serum transferrin to total iron-binding capacity for nutritional assessment. JPEN6:392-394, 1982
27.
Ingenbleek Y., Van Den Schrieck HG, De Nayer P.: Albumin, transferrin and thyroxine-binding prealbumin/retinol-binding protein (TBPA-RBP) complex in assessment of malnutrition. Clin Chim Acta63:61-67, 1975
28.
Best WR, Becktel JM, Singleton JW, et al: Development of a Crohn's disease activity index. Gastroenterology70:439-444, 1976
29.
Waxman S.: The value of measurement of folate levels by radioassay. IN Folic Acid in Neurology, Psychiatry, and Internal Medicine, Botez IM, Reynolds EH , (eds). Raven Press, New York , 1979, pp 47-53
30.
Solomons NWRosenberg IHSanstead HH, et al: Zinc deficiency in Crohn's disease . Digestion16:87-95. 1977
31.
McClain C.Soutor C.Zieve L.: Zinc deficiency: A complication of Crohn's disease. Gastroenterology78:272-297. 1980
32.
Nishi Y.Lifshits F.Bayne MA et al: Zinc status and its relation to growth retardation in children with chronic inflammatory bowel disease. Am J Clin Nutr33:2613-2621, 1980
33.
Fleming CR, Huizega KA, Mc Call JT, et al: Zinc nutrition in Crohn's disease. Dig Dis Sci26:865-870, 1981
34.
Main ANH.Hall MJRussell RI, et al: Clinical experience of zinc supplementation during intravenous nutrition in Crohn's disease: Value of serum and urine measurements. Gut23:984-991, 1982
35.
Nelder KH, Hambidge KM: Zinc therapy of acrodermatitis enteropathica. N Engl J Med292:879-882. 1975
36.
Baer MT, King JC: Tissue zinc levels and zinc excretion during experimental zinc depletion in young men. Am J Clin Nutr39:556-570, 1984
Long CL, Haverberg LN, Young VR, et al: Metabolism of 3-methylhistidine in man. Metabolism24:929-935, 1975
39.
Long CL, Birkhan RH, Geiger JW, et al: Urinary excretion of 3-methylhistidine : An assessment of muscle protein catabolism in adult normal subjects and during malnutrition, sepsis, and skeletal trauma. Metabolism30:765-776, 1981
