scholarly journals Small and Large Intestine (I): Malabsorption of Nutrients

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1254
Author(s):  
Miguel A. Montoro-Huguet ◽  
Blanca Belloc ◽  
Manuel Domínguez-Cajal
Keyword(s):  
Gastrointestinal Symptoms ◽  
Extraintestinal Manifestations ◽  
Physiological Mechanisms ◽  
Clinical Consequences ◽  
Mucosal Absorption ◽  
Underlying Diseases ◽  
Hydrolysis Of ◽  
Uptake Of Nutrients ◽  
Small And Large Intestine ◽  
Pathophysiologic Mechanisms

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.

Invited Review: Clearance of lung liquid during the perinatal period

2002 ◽  
Vol 93 (4) ◽  
pp. 1542-1548 ◽  
Author(s):  
Pierre M. Barker ◽  
Richard E. Olver
Keyword(s):  
Developmental Regulation ◽  
Perinatal Period ◽  
Lung Epithelium ◽  
Physiological Mechanisms ◽  
Transgenic Cell ◽  
Membrane Transport Proteins ◽  
Liquid Absorption ◽  
Clinical Consequences ◽  
Distal Lung ◽  
Lung Liquid

At birth, the distal lung epithelium undergoes a profound phenotypic switch from secretion to absorption in the course of adaptation to air breathing. In this review, we describe the developmental regulation of key membrane transport proteins and the way in which epinephrine, oxygen, glucocorticoids, and thyroid hormones interact to bring about this crucial change in function. Evidence from molecular, transgenic, cell culture, and whole lung studies is presented, and the clinical consequences of the failure of the physiological mechanisms that underlie perinatal lung liquid absorption are discussed.

Dietary approaches to alleviation of lactose maldigestion / Efectos de la dieta sobre la digestión de la lactosa

1997 ◽  
Vol 3 (2) ◽  
pp. 71-79 ◽  
Author(s):  
E. Renner
Keyword(s):  
Lactic Acid ◽  
Adverse Effects ◽  
Dairy Products ◽  
Gastrointestinal Symptoms ◽  
Colonic Fermentation ◽  
Lactose Malabsorption ◽  
Dairy Foods ◽  
Solid Foods ◽  
Lactose Maldigestion ◽  
Hydrolysis Of

Because dairy products are a significant source of essential nutrients, elimination of all dairy foods in the diet would be nutritionally unwise and is usually not necessary in the case of lactose maldigestion. About 250 ml milk/d can generally be taken without adverse effects. If milk is taken in combination with solid foods, lactose malabsorption may be reduced by about 50%, probably due to a slower rate of colonic fermentation which may lower gastrointestinal symptoms in lactose malabsorbers. It is well established that, in lactase-deficient subjects, yoghurt is better tolerated than milk. This is only to some extent related to the fact that the lactose content of the products is reduced during fermentation, but is mainly attributed to the fact that the culture organisms- by virtue of being rich in lactase - are able to participate in the hydrolysis of ingested lactose. Up to 20 g of lactose in yoghurt is tolerated well by lactase-deficient persons. The enhanced absorp tion of lactose in yoghurt is explained as a result of the intestinal release of lactase from the yoghurt organisms. Ripened cheese is also tolerated very well by lactose-intolerant persons since virtually all of the lactose present is decomposed to lactic acid and other metabolites.

scholarly journals Tolerance of arabinoxylan-oligosaccharides and their prebiotic activity in healthy subjects: a randomised, placebo-controlled cross-over study

2009 ◽  
Vol 103 (5) ◽  
pp. 703-713 ◽  
Author(s):  
Lieselotte Cloetens ◽  
Willem F. Broekaert ◽  
Yasmine Delaedt ◽  
Frans Ollevier ◽  
Christophe M. Courtin ◽  
...  
Keyword(s):  
Healthy Subjects ◽  
Blood Lipids ◽  
Clinical Chemistry ◽  
Human Subjects ◽  
Gastrointestinal Symptoms ◽  
Oral Intake ◽  
Blood Parameters ◽  
Normal Range ◽  
Healthy Human ◽  
Hydrolysis Of

The tolerance and prebiotic effect following oral intake by healthy human subjects of arabinoxylan-oligosaccharides (AXOS), produced by partial enzymic hydrolysis of the wheat fibre arabinoxlyan, were studied. A total of twenty healthy subjects participated in the present randomised, placebo-controlled cross-over study. They consumed 10 g AXOS or placebo per d each for 3 weeks with a 4-week wash-out period in between. Before and immediately after each intake period, blood samples were taken to measure haematological and clinical chemistry parameters and the subjects completed a questionnaire about gastrointestinal symptoms. Additionally, urine was collected over 48 h for analysis ofp-cresol and phenol content by GC–MS, and faeces were collected over 72 h for analysis of microbiota using real-time PCR. Of the subjects, ten also performed a urine and faeces collection 2 weeks after the start of intake (during intervention). A limited number of tested blood parameters were influenced in a statistically significantly way by either AXOS or placebo intake, but these changes remained within the normal range. Blood lipids remained unchanged. AXOS had no statistically significant effect on the range of gastrointestinal symptoms, except for a mild increase in flatulence. Urinaryp-cresol excretion, an indicator of protein fermentation, was significantly decreased after 2 weeks of AXOS intake. The levels of bifidobacteria were significantly increased after 2 and 3 weeks of AXOS intake as well as after 3 weeks of placebo. However, the effect of AXOS on bifidobacteria was more pronounced than that of placebo. In conclusion, AXOS are a well-tolerated prebiotic at the dose of 10 g/d. AXOS intake increases faecal bifidobacteria and reduces urinaryp-cresol excretion.

scholarly journals Effects of a Gluten-Containing Meal on Gastric Emptying and Gallbladder Contraction

Nutrients ◽  
2018 ◽  
Vol 10 (7) ◽  
pp. 910 ◽  
Author(s):  
Sara Massironi ◽  
Federica Branchi ◽  
Mirella Fraquelli ◽  
Alessandra Baccarin ◽  
Francesco Somalvico ◽  
...  
Keyword(s):  
Gastric Emptying ◽  
Gastrointestinal Symptoms ◽  
Gallbladder Motility ◽  
Pathophysiological Mechanism ◽  
Gluten Free ◽  
Physiological Mechanisms ◽  
Gallbladder Contraction ◽  
Ultrasound Evaluation ◽  
Contraction And Relaxation ◽  
Filling Curve

The ingestion of gluten has been associated with gastrointestinal symptoms even in the absence of detectable immune responses. Little is known about the pathophysiological effects of gluten on the upper gastrointestinal tract. We aimed to assess whether the ingestion of gluten leads to an impairment of the physiological mechanisms of gastric emptying, gallbladder contraction and relaxation. A total of 17 healthy subjects underwent ultrasound evaluation of gastric emptying dynamics and gallbladder contractions at baseline and every 30 min after a standard gluten-containing and gluten-free meal (250 kcal, 70% carbohydrates). The pattern of gastric emptying was similar after a standard meal with or without gluten, but differed in terms of the peak of the antral filling curve, which was wider (mean area 5.69, median 4.70, range 3.71‒9.27 cm2 vs. mean 4.89, median 4.57, 2.27‒10.22 cm2, p = 0.023) after the gluten-containing meal. The pattern of gallbladder contractions was different after the gluten-free meal (p < 0.05), with higher gallbladder volumes in the late refilling phases. The results of this study show that gluten ingestion exerts objective effects on gastric and gallbladder motility. Although the underlying pathophysiological mechanism remains unknown, these results could account for some of the gluten-related symptoms reported by patients with celiac disease and non-celiac gluten sensitivity.

scholarly journals Extraintestinal Manifestations of Celiac Disease: Early Detection for Better Long-Term Outcomes

Nutrients ◽  
2018 ◽  
Vol 10 (8) ◽  
pp. 1015 ◽  
Author(s):  
Pilvi Laurikka ◽  
Samuli Nurminen ◽  
Laura Kivelä ◽  
Kalle Kurppa
Keyword(s):  
Celiac Disease ◽  
Gastrointestinal Symptoms ◽  
Great Majority ◽  
Gastrointestinal Diseases ◽  
Population Based ◽  
Extraintestinal Manifestations ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Factors Affecting

Population-based screening studies have shown celiac disease to be one of the most common chronic gastrointestinal diseases. Nevertheless, because of the diverse clinical presentation, the great majority of patients remain unrecognized. Particularly difficult to identify are the multifaceted extraintestinal symptoms that may appear at variable ages. Although the pathogenesis and long-term outcome of these manifestations are still poorly established, there is some evidence that unrecognized celiac disease predisposes to severe complications if not diagnosed and prevented with an early-initiated gluten-free diet. Therefore, it is of utmost importance that physicians of different disciplines learn to recognize celiac disease in individuals with non-gastrointestinal symptoms. In the future, more studies are needed to clarify the factors affecting development and prognosis of the extraintestinal manifestations.

Renal assimilation of oligopeptides: physiological mechanisms and metabolic importance

1997 ◽  
Vol 272 (5) ◽  
pp. E723-E736 ◽  
Author(s):  
S. A. Adibi
Keyword(s):  
Metabolic Regulation ◽  
Human Subjects ◽  
Genetic Diseases ◽  
Plasma Concentrations ◽  
High Capacity ◽  
Systemic Circulation ◽  
Physiological Mechanisms ◽  
Renal Cell Line ◽  
Dipeptide Transport ◽  
Hydrolysis Of

Assimilation of systemic oligopeptides (di- and tripeptides) is largely a function of kidneys. The most specific and unique mechanism utilized for the performance of this renal function is transport, followed by intracellular hydrolysis and then release of constituent amino acids to the systemic circulation. Among tissues examined (liver, kidney, intestine, and muscle), kidney is the only tissue capable of accumulating dipeptides in concentrations that are greater than their plasma concentrations. Kidney also is the tissue with the highest cytoplasmic dipeptidase activity. Intracellular accumulation is mediated by two transporters (Pept-1 and Pept-2), both of which have been recently cloned. These transporters use dipeptides and tripeptides as substrates and rely on protons and membrane potential for their driving force. Pept-1 is a low-affinity, high-capacity transporter, and Pept-2 is a high-affinity, low-capacity transporter. The nutritional and metabolic regulation of renal assimilation of oligopeptides is suggested by the selective decrease in dipeptide balance across the kidneys of starved human subjects and by the insulin stimulation of dipeptide transport by a renal cell line. Peptiduria has been observed in a variety of diseases, but the mechanism, except in genetic diseases affecting hydrolysis of oligopeptides, is not known. Finally, the capacity for active transport of oligopeptides and peptidomimetic drugs enables kidneys to play major roles in nutritional and pharmacological therapies.

scholarly journals A gluténérzékenység extraintestinalis spektruma

2019 ◽  
Vol 160 (34) ◽  
pp. 1327-1334
Author(s):  
István Fedor ◽  
Éva Zöld ◽  
Zsolt Barta
Keyword(s):  
Gastrointestinal Disease ◽  
Wide Spectrum ◽  
Gastrointestinal Symptoms ◽  
Autoimmune Disorder ◽  
Gluten Sensitivity ◽  
Age Group ◽  
Extraintestinal Manifestations ◽  
Gluten Sensitive Enteropathy ◽  
Paediatric Age ◽  
Delayed Recognition

Abstract: Although celiac disease (gluten-sensitive enteropathy) is a relatively well known malady, yet is surrounded by several misconceptions. It is in fact, a multi-systemic autoimmune disorder with a wide spectrum of possible presentations, though most clinicians regard it as a solely gastrointestinal disease. Another misconception that it is a disease of paediatric age group. Thus, the diagnosis of adult or elderly patients is often delayed. Recognition of the disease in the adults can be challenging, as there are less pronounced gastrointestinal symptoms, and patients present with other manifestations (i.e., neurologic, cardiovascular, hepatobiliary, or hematologic involvement are common). As these extraintestinal manifestations are less well known among practicing physicians, here we propose a brief overview of these. We aimed to summarize the available literature on the extraintestinal manifestations associated with gluten sensitivity. Orv Hetil. 2019; 160(34): 1327–1334.

scholarly journals Membrane Filtration-Assisted Enzymatic Hydrolysis Affects the Biological Activity of Potato Juice

Molecules ◽  
2021 ◽  
Vol 26 (4) ◽  
pp. 852
Author(s):  
Przemysław Łukasz Kowalczewski ◽  
Anna Olejnik ◽  
Iga Rybicka ◽  
Magdalena Zielińska-Dawidziak ◽  
Wojciech Białas ◽  
...  
Keyword(s):  
Biological Activity ◽  
Enzymatic Hydrolysis ◽  
Cell Line ◽  
Membrane Filtration ◽  
Nutritional Value ◽  
Protein Hydrolysate ◽  
Gastrointestinal Symptoms ◽  
Human Colon Cancer ◽  
The Impact ◽  
Hydrolysis Of

The results of recently published studies indicate that potato juice is characterized by interesting biological activity that can be particularly useful in the case of gastrointestinal symptoms. Moreover, the studies also described the high nutritional value of its proteins. This article is a report on the impact of the enzymatic hydrolysis of proteins combined with membrane filtration. The obtained potato juice protein hydrolysate (PJPH) and its concentrate (cPJPH) were characterized in terms of their nutritional value and biological activity. The amino acid profile and scoring, the content of mineral compounds, and the antioxidant and in vitro cytotoxic activity were assessed. The study proved that the antioxidant activity of PJPH is higher than that of fresh potato juice, and the cytotoxicity against human gastric carcinoma cell line (Hs 746T), human colon cancer cell line (Caco-2), human colorectal adenocarcinoma cell line (HT-29), and human normal colon mucosa cell line (CCD 841 CoN) showed biological activity specifically targeted against cancer cells. Therefore, it can be concluded that the membrane filtration-assisted enzymatic hydrolysis of potato juice proteins may increase their biological activity and allow for potato juice to be used in the production of medicinal preparations.

scholarly journals Acrodystrophic axonal polyneuropathy with celiac disease: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
S. N. Bardakov ◽  
Minh Duc Tran ◽  
S. V. Lapin ◽  
A. N. Moshnikova ◽  
E. U. Kalinina ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Immunosuppressive Treatment ◽  
Gastrointestinal Symptoms ◽  
Lower Extremities ◽  
Duodenal Mucosa ◽  
Extraintestinal Manifestations ◽  
Histological Changes ◽  
Treatment Protocols ◽  
Axonal Polyneuropathy ◽  
Wide Range

Abstract Background Patients with celiac disease present with not only gastrointestinal symptoms but also extraintestinal manifestations such as anemia, osteopathy, dermatitis herpetiformis, and celiac neuropathy. Despite a fairly wide range of celiac neuropathies, we report a case of the acrodystrophic variant of celiac polyneuropathy, which has not been previously described. Case presentation A 41-year-old Ukrainian male suffered from symmetric, sensorimotor axonal polyneuropathy and encephalopathy associated with celiac disease, which is characterized by severe trophic disorders in the lower extremities (trophic ulcers, hyperkeratosis, and anhidrosis). Acrodystrophic changes in the lower extremities were due to both neurogenic and direct immunoinflammatory damaging effects. Clinical–electrophysiological dissociation was also noted, which was represented by a gross axonal lesion with the preservation of muscle strength. The absence of enteropathic manifestations was accompanied by the pronounced histological changes in the duodenal mucosa by IIIb stage of Marsh. A gluten-free diet in combination with membrane plasma exchange and intravenous pulse methylprednisolone was prescribed to reduce the severity of sensory disorders and regression of encephalopathy within 7 months. Conclusion Celiac disease may be a potential cause of neuropathy and encephalopathy in adult patients. Further immunosuppressive treatment protocols for both intestinal and extraintestinal manifestations of celiac disease are required.

scholarly journals Autoantibodies in the Extraintestinal Manifestations of Celiac Disease

Nutrients ◽  
2018 ◽  
Vol 10 (8) ◽  
pp. 1123 ◽  
Author(s):  
Xuechen Yu ◽  
Melanie Uhde ◽  
Peter Green ◽  
Armin Alaedini
Keyword(s):  
Celiac Disease ◽  
Gastrointestinal Symptoms ◽  
Transglutaminase 2 ◽  
The Body ◽  
Extraintestinal Manifestations ◽  
Cell Reactivity ◽  
Pathogenic Potential ◽  
Transglutaminase 3 ◽  
Diagnostic And Prognostic Value

Increased antibody reactivity towards self-antigens is often indicative of a disruption of homeostatic immune pathways in the body. In celiac disease, an autoimmune enteropathy triggered by the ingestion of gluten from wheat and related cereals in genetically predisposed individuals, autoantibody reactivity to transglutaminase 2 is reflective of the pathogenic role of the enzyme in driving the associated inflammatory immune response. Autoantibody reactivity to transglutaminase 2 closely corresponds with the gluten intake and clinical presentation in affected patients, serving as a highly useful biomarker in the diagnosis of celiac disease. In addition to gastrointestinal symptoms, celiac disease is associated with a number of extraintestinal manifestations, including those affecting skin, bones, and the nervous system. Investigations of these manifestations in celiac disease have identified a number of associated immune abnormalities, including B cell reactivity towards various autoantigens, such as transglutaminase 3, transglutaminase 6, synapsin I, gangliosides, and collagen. Clinical relevance, pathogenic potential, mechanism of development, and diagnostic and prognostic value of the various identified autoantibody reactivities continue to be subjects of investigation and will be reviewed here.

Sign in / Sign up

Export Citation Format

Share Document