Sprue, Tropical
Collagenous Sprue
Celiac Disease
Glutens
Jejunum
Gliadin
Diet, Gluten-Free
Transglutaminases
Dermatitis Herpetiformis
Xylose
Intestinal Mucosa
Malabsorption Syndromes
Intestine, Small
Erythritol
Sphingomonas
Endemic tropical sprue in Rhodesia. (1/33)
The existence of tropical sprue in Africa is controversial. In this paper we present 31 cases seen in Rhodesia over a 15 month period. They have the clinical features, small intestinal morphology, malabsorption pattern, and treatment response of tropical sprue. Other causes of malabsorption, and primary malnutrition, have been excluded. The severity of the clinical state and intestinal malabsorption distinguish these patients from those we have described with tropical enteropathy. The previous work on tropical sprue in Africa is reviewed and it is apparent that, when it has been adequately looked for, it has been found. It is clear that the question of tropical sprue in Africa must be re-examined and that it existence may have hitherto been concealed by the assumption that primary malnutrition is responsible for the high prevalence of deficiency states. (+info)Tropical enteritis: nutritional consequences and connections with the riddle of cholera. (2/33)
One of the important consequences of the infection-nutrition interaction is mediated by malabsorption associated with chronic inflammation in the intestine, enteritis. Studies made possible after development of the peroral intestinal biopsy technique in the 1950s indicated the wide prevalence of enteropathy, particularly in tropical developing countries with poor levels of sanitation. Some consider this so-called subclinical tropical malabsorption to be the base of an iceberg, whose tip is tropical sprue, a severe form of malabsorption leading to nutritional deficiency that had been reported in colonial expatriates in tropical countries for 200 y. Some of the first demonstrations of the prevalence of tropical enteritis in Asia were made in quest of the pathologic lesion of cholera, and further examination of the water and electrolyte, as well as nutrient, malabsorption in cholera led serendipitously to the discovery of the oral rehydration solution for the treatment of diarrheal disease. (+info)Idiopathic enteropathy: an evaluation in rural Iran with an appraisal of nutrient loss. (3/33)
Idiopathic enteropathy in the rural population of Iran was investigated through evaluation of 100 randomly selected apparently normal subjects. The evaluation included quantitation of the nutrient loss, presence of malabsorption, and small intestinal morphological abnormalities. The results show that: 1) there was no significant loss of major nutrients, 2) severe malabsorption was not present, 3) an enteropathy of unknown etiology was found in nearly one-third of the subjects, and 4) abnormalities in morphology did not necessarily mean presence of malabsorption. (+info)Tropical malabsorption. (4/33)
Malabsorption is an important clinical problem both in visitors to the tropics and in native residents of tropical countries. Infections of the small intestine are the most important cause of tropical malabsorption. Protozoal infections cause malabsorption in immunocompetent hosts, but do so more commonly in the setting of immune deficiency. Helminth infections occasionally cause malabsorption or protein-losing enteropathy. Intestinal tuberculosis, chronic pancreatitis and small-bowel bacterial overgrowth are important causes of tropical malabsorption. In recent years, inflammatory bowel disease and coeliac disease have become major causes of malabsorption in the tropics. Sporadic tropical sprue is still an important cause of malabsorption in adults and in children in South Asia. Investigations to exclude specific infective, immunological or inflammatory causes are important before considering tropical sprue as a diagnosis. This article briefly reviews the management of tropical sprue and presents an algorithm for its investigation and management. (+info)13C-sucrose breath test: novel use of a noninvasive biomarker of environmental gut health. (5/33)
(+info)Spectrum of malabsorption syndrome among adults & factors differentiating celiac disease & tropical malabsorption. (6/33)
BACKGROUND & OBJECTIVES: Aetiology of malabsorption syndrome (MAS) differs in tropical and temperate countries over time; clinical and laboratory parameters may differentiate between various causes. This study was undertaken to investigate the spectrum of MAS among Indian adults and to find out the features that may help to differentiate between TM and celiac disease. METHODS: Causes of MAS, and factors differentiating tropical malabsorption (TM) from celiac disease (CD) were determined in 275 patients. RESULTS: Using standard criteria, causes in 275 patients [age 37.5+13.2 yr, 170, (61.5%) male] were, TM 101 (37%), CD 53 (19%), small intestinal bacterial overgrowth 28 (10%), AIDS 15 (5.4%), giardiasis 13 (5%), hypogammaglobulinemia 12 (4%), intestinal tuberculosis 7 (2.5%), strongyloidiasis 6 (2%), immunoproliferative small intestinal disease 5 (2%), Crohn's disease 6 (2%), amyloidosis 4 (1.5%), intestinal lymphangiectasia 3 (1%) and unknown 22 (8%). On univariate analysis, patients with CD were younger than TM (30.6+12 vs. 39.3+12.6 yr, P<0.001), had lower body weight (41.3+11.8 vs. 49.9+11.2 kg, P<0.001), longer diarrhoea duration (median 36 inter-quartile range 17.8-120 vs. 24-months, 8-48, P<0.01), lower stool frequency (6/day, 5-8 vs. 8, 5-10, P<0.05), lower haemoglobin (9.4+3.2 vs. 10.4+2.7 g/dl, P<0.05), higher platelet count (2,58,000, range 1,35,500-3,23,500 vs. 1,60,000, 1,26,000-2,58,000/mm 3 , P<0.05), and more often had hepatomegaly (9/53, 17% vs. 4/101, 4%, P<0.01), and subtotal or partial villous atrophy (36/50, 72% vs. 28/87, 32%, P<0.001). Younger age (<35 yr), longer diarrhoea duration, higher platelet count and villous atrophy were significant on multivariate analysis. INTERPRETATION & CONCLUSIONS: TM and CD are common causes of MAS among Indian adults. Younger age (<35 yr), longer diarrhoea duration, higher platelet count and villous atrophy were found to be associated with CD. (+info)Diarrhoea due to small bowel diseases. (7/33)
(+info)Pathogenesis of tropical sprue: a pilot study of antroduodenal manometry, duodenocaecal transit time & fat-induced ileal brake. (8/33)
BACKGROUND & OBJECTIVES: Small intestinal bacterial overgrowth (SIBO) due to ileal brake-induced hypomotility may cause tropical sprue (TS). We evaluated effect of infusion of fat or placebo in duodenum randomly in patients with TS and healthy controls on antroduodenal manometry (ADM) and mediators of ileal brake, and duodenocaecal transit time (DCTT). METHODS: ADM and DCTT (lactulose hydrogen breath test, HBT) were evaluated with placebo and fat in eight controls and 13 patients with TS (diagnostic criteria: tests showing malabsorption of two unrelated substances, abnormal duodenal histology, absence of other causes, response to antibiotics and folate). RESULTS: Patients with TS (6 had SIBO by glucose HBT) were similar in age and gender with controls. After fat infusion, proximal gut motility index (MI) was reduced compared to fasting state in TS, and DCTT was longer in TS than controls (200 min, 120-380 vs. 130, 70-160, P=0.001), though comparable after placebo (70 min, 30-140 vs. 60, 40-90). TS patients had higher PYY and neurotensin than controls after fat infusion. DCTT after fat infusion correlated with plasma level of PYY in TS but not in controls. Post-fat PYY and neurotensin levels were higher in TS with lower BMI (<16 kg/m [2] ) than those with higher BMI. Parameters of ileal brake (post-fat DCTT, PYY and neurotensin) were higher in patients with than without SIBO. INTERPRETATION & CONCLUSIONS: Fat infusion reduced proximal gut MI, increased DCTT, PYY, and neurotensin among patients with TS. Malabsorbed fat might cause exaggerated ileal brake reducing gut motility, promoting SIBO and bacterial colonization and malabsorption in TS. (+info)Tropical sprue is a malabsorption disorder that is most commonly found in tropical or subtropical regions. It is characterized by symptoms such as chronic diarrhea, weight loss, and fatigue, which are caused by the impaired absorption of nutrients in the small intestine.
The exact cause of tropical sprue is not known, but it is thought to be related to an infection or other environmental factor that damages the lining of the small intestine. This damage can interfere with the absorption of nutrients, particularly fat-soluble vitamins and minerals such as vitamin B12, iron, and folate.
Tropical sprue is typically treated with a combination of antibiotics to eliminate any potential infectious causes, as well as a diet that is high in nutrients and low in fat. In severe cases, supplementation with fat-soluble vitamins and other nutrients may be necessary. With appropriate treatment, most people with tropical sprue are able to recover and manage their symptoms.
Collagenous sprue, also known as collagenous colitis, is a medical condition that affects the inner lining of the colon. It is characterized by inflammation and the accumulation of collagen, a protein that provides structure to tissues and organs, beneath the epithelial cells of the colon.
Collagenous sprue is a type of microscopic colitis, which means that it can only be diagnosed through a biopsy of the colon tissue. The exact cause of collagenous sprue is not known, but it is thought to be related to an abnormal immune response or an injury to the lining of the colon.
Symptoms of collagenous sprue may include chronic watery diarrhea, abdominal cramps, bloating, and nausea. In some cases, people with collagenous sprue may also experience weight loss and fatigue. The condition is more common in middle-aged women and tends to affect the distal colon, which is the part of the colon closest to the rectum.
Treatment for collagenous sprue typically involves medications to reduce inflammation and control diarrhea, such as anti-inflammatory drugs, corticosteroids, and bulking agents. In severe cases, surgery may be necessary to remove a portion of the colon. Collagenous sprue is generally not considered a life-threatening condition, but it can significantly impact quality of life and lead to complications such as dehydration and malnutrition if left untreated.
Celiac disease is a genetic autoimmune disorder in which the consumption of gluten, a protein found in wheat, barley, and rye, leads to damage in the small intestine. In people with celiac disease, their immune system reacts to gluten by attacking the lining of the small intestine, leading to inflammation and destruction of the villi - finger-like projections that help absorb nutrients from food.
This damage can result in various symptoms such as diarrhea, bloating, fatigue, anemia, and malnutrition. Over time, if left untreated, celiac disease can lead to serious health complications, including osteoporosis, infertility, neurological disorders, and even certain types of cancer.
The only treatment for celiac disease is a strict gluten-free diet, which involves avoiding all foods, beverages, and products that contain gluten. With proper management, individuals with celiac disease can lead healthy lives and prevent further intestinal damage and related health complications.
"Gluten" is not strictly defined as a medical term, but it refers to a group of proteins found in certain grains, including wheat, barley, and rye. Gluten gives these grains their elasticity and helps them maintain their shape, making it possible to bake breads and other baked goods.
From a medical perspective, gluten is significant because some people have adverse reactions to it. The two main conditions related to gluten are celiac disease and non-celiac gluten sensitivity. In both cases, consuming gluten can lead to various symptoms such as gastrointestinal distress, fatigue, and skin rashes.
Celiac disease is an autoimmune disorder where the ingestion of gluten causes damage to the small intestine lining, impairing nutrient absorption. On the other hand, non-celiac gluten sensitivity does not involve an immune response or intestinal damage but can still cause uncomfortable symptoms in some individuals.
It is essential to understand that a gluten-free diet should be medically recommended and supervised by healthcare professionals for those diagnosed with celiac disease or non-celiac gluten sensitivity, as it may lead to nutritional deficiencies if not properly managed.
The jejunum is the middle section of the small intestine, located between the duodenum and the ileum. It is responsible for the majority of nutrient absorption that occurs in the small intestine, particularly carbohydrates, proteins, and some fats. The jejunum is characterized by its smooth muscle structure, which allows it to contract and mix food with digestive enzymes and absorb nutrients through its extensive network of finger-like projections called villi.
The jejunum is also lined with microvilli, which further increase the surface area available for absorption. Additionally, the jejunum contains numerous lymphatic vessels called lacteals, which help to absorb fats and fat-soluble vitamins into the bloodstream. Overall, the jejunum plays a critical role in the digestion and absorption of nutrients from food.
Gliadin is a protein fraction found in gluten, a complex protein that's present in certain grains such as wheat, barley, and rye. It is particularly known for its role in celiac disease, a disorder where the ingestion of gluten leads to an immune response that damages the lining of the small intestine.
Gliadin, along with another protein fraction called glutenin, makes up gluten. Gliadin is responsible for the elastic properties of dough. When water is added to flour and mixed, these proteins form a sticky network that gives dough its characteristic texture and allows it to rise and maintain its shape during baking.
In individuals with celiac disease, the immune system recognizes gliadin as a foreign invader and mounts an immune response against it. This response leads to inflammation and damage in the small intestine, preventing the absorption of nutrients from food. Over time, this can lead to various health complications if not properly managed through a gluten-free diet.
A gluten-free diet is a diet that excludes the consumption of gluten, a protein found in wheat, barley, and rye. This type of diet is often recommended for individuals with celiac disease, non-celiac gluten sensitivity, or wheat allergies. Adhering to a strict gluten-free diet can help manage symptoms, heal intestinal damage, and prevent further complications associated with these conditions.
The medical definition of 'Diet, Gluten-Free' includes:
1. Celiac Disease: An autoimmune disorder where the ingestion of gluten leads to damage in the small intestine. Following a gluten-free diet is crucial for individuals with celiac disease to prevent symptoms and associated health complications.
2. Non-Celiac Gluten Sensitivity (NCGS): A condition where individuals experience adverse reactions to gluten, but do not test positive for celiac disease or wheat allergy. A gluten-free diet can help alleviate symptoms in those with NCGS.
3. Wheat Allergy: An allergic reaction to proteins found in wheat, which may include gluten. Excluding gluten from the diet can help manage symptoms in individuals with wheat allergy.
4. Dermatitis Herpetiformis (DH): A skin manifestation of celiac disease characterized by an itchy, blistering rash. A gluten-free diet is often recommended to control DH symptoms and prevent intestinal damage.
5. Gluten Ataxia: A neurological disorder associated with celiac disease where gluten ingestion can cause issues with balance, coordination, and speech. A gluten-free diet may help improve these symptoms in individuals with gluten ataxia.
It is essential to consult a healthcare professional or a registered dietitian for guidance on following a gluten-free diet to ensure proper nutrition and to avoid cross-contamination from gluten sources.
Glycylglycine is not a medical condition or term, but rather it is a chemical compound. It is a dipeptide, which means it is composed of two amino acids linked together. Specifically, glycylglycine consists of two glycine molecules joined by an amide bond (also known as a peptide bond) between the carboxyl group of one glycine and the amino group of the other glycine.
Glycylglycine is often used in laboratory research as a buffer, a substance that helps maintain a stable pH level in a solution. It has a relatively simple structure and is not naturally found in significant amounts in living organisms.
Transglutaminases are a family of enzymes that catalyze the post-translational modification of proteins by forming isopeptide bonds between the carboxamide group of peptide-bound glutamine residues and the ε-amino group of lysine residues. This process is known as transamidation or cross-linking. Transglutaminases play important roles in various biological processes, including cell signaling, differentiation, apoptosis, and tissue repair. There are several types of transglutaminases, such as tissue transglutaminase (TG2), factor XIII, and blood coagulation factor XIIIA. Abnormal activity or expression of these enzymes has been implicated in various diseases, such as celiac disease, neurodegenerative disorders, and cancer.
Dermatitis herpetiformis (DH) is a chronic, autoimmune blistering skin disorder that is characterized by the presence of symmetrical, pruritic (itchy), papulo-vesicular (papules and small fluid-filled blisters) eruptions on the extensor surfaces of the body, such as the elbows, knees, buttocks, and shoulders. It is often associated with gluten sensitivity or celiac disease, a condition that causes an abnormal immune response to gluten, a protein found in wheat, barley, and rye.
The exact cause of DH is not fully understood, but it is believed to result from the interaction between genetic, environmental, and immunological factors. The disorder is characterized by the presence of IgA antibodies in the skin, which trigger an immune response that leads to the formation of the characteristic rash.
DH is typically treated with a gluten-free diet, which can help to control the symptoms and prevent complications such as malabsorption and nutritional deficiencies. Medications such as dapsone may also be used to control the itching and blistering associated with the disorder. In some cases, topical corticosteroids or other anti-inflammatory medications may be prescribed to help manage symptoms.
It is important to note that DH is a chronic condition that requires ongoing management and monitoring. People with DH should work closely with their healthcare provider to develop an appropriate treatment plan and monitor their progress over time.
Xylose is a type of sugar that is commonly found in plants and wood. In the context of medical definitions, xylose is often used in tests to assess the function of the small intestine. The most common test is called the "xylose absorption test," which measures the ability of the small intestine to absorb this sugar.
In this test, a patient is given a small amount of xylose to drink, and then several blood and/or urine samples are collected over the next few hours. The amount of xylose that appears in these samples is measured and used to determine how well the small intestine is absorbing nutrients.
Abnormal results on a xylose absorption test can indicate various gastrointestinal disorders, such as malabsorption syndromes, celiac disease, or bacterial overgrowth in the small intestine.
The intestinal mucosa is the innermost layer of the intestines, which comes into direct contact with digested food and microbes. It is a specialized epithelial tissue that plays crucial roles in nutrient absorption, barrier function, and immune defense. The intestinal mucosa is composed of several cell types, including absorptive enterocytes, mucus-secreting goblet cells, hormone-producing enteroendocrine cells, and immune cells such as lymphocytes and macrophages.
The surface of the intestinal mucosa is covered by a single layer of epithelial cells, which are joined together by tight junctions to form a protective barrier against harmful substances and microorganisms. This barrier also allows for the selective absorption of nutrients into the bloodstream. The intestinal mucosa also contains numerous lymphoid follicles, known as Peyer's patches, which are involved in immune surveillance and defense against pathogens.
In addition to its role in absorption and immunity, the intestinal mucosa is also capable of producing hormones that regulate digestion and metabolism. Dysfunction of the intestinal mucosa can lead to various gastrointestinal disorders, such as inflammatory bowel disease, celiac disease, and food allergies.
Malabsorption syndromes refer to a group of disorders in which the small intestine is unable to properly absorb nutrients from food, leading to various gastrointestinal and systemic symptoms. This can result from a variety of underlying conditions, including:
1. Mucosal damage: Conditions such as celiac disease, inflammatory bowel disease (IBD), or bacterial overgrowth that cause damage to the lining of the small intestine, impairing nutrient absorption.
2. Pancreatic insufficiency: A lack of digestive enzymes produced by the pancreas can lead to poor breakdown and absorption of fats, proteins, and carbohydrates. Examples include chronic pancreatitis or cystic fibrosis.
3. Bile acid deficiency: Insufficient bile acids, which are necessary for fat emulsification and absorption, can result in steatorrhea (fatty stools) and malabsorption. This may occur due to liver dysfunction, gallbladder removal, or ileal resection.
4. Motility disorders: Abnormalities in small intestine motility can affect nutrient absorption, as seen in conditions like gastroparesis, intestinal pseudo-obstruction, or scleroderma.
5. Structural abnormalities: Congenital or acquired structural defects of the small intestine, such as short bowel syndrome, may lead to malabsorption.
6. Infections: Certain bacterial, viral, or parasitic infections can cause transient malabsorption by damaging the intestinal mucosa or altering gut flora.
Symptoms of malabsorption syndromes may include diarrhea, steatorrhea, bloating, abdominal cramps, weight loss, and nutrient deficiencies. Diagnosis typically involves a combination of clinical evaluation, laboratory tests, radiologic imaging, and sometimes endoscopic procedures to identify the underlying cause. Treatment is focused on addressing the specific etiology and providing supportive care to manage symptoms and prevent complications.
The small intestine is the portion of the gastrointestinal tract that extends from the pylorus of the stomach to the beginning of the large intestine (cecum). It plays a crucial role in the digestion and absorption of nutrients from food. The small intestine is divided into three parts: the duodenum, jejunum, and ileum.
1. Duodenum: This is the shortest and widest part of the small intestine, approximately 10 inches long. It receives chyme (partially digested food) from the stomach and begins the process of further digestion with the help of various enzymes and bile from the liver and pancreas.
2. Jejunum: The jejunum is the middle section, which measures about 8 feet in length. It has a large surface area due to the presence of circular folds (plicae circulares), finger-like projections called villi, and microvilli on the surface of the absorptive cells (enterocytes). These structures increase the intestinal surface area for efficient absorption of nutrients, electrolytes, and water.
3. Ileum: The ileum is the longest and final section of the small intestine, spanning about 12 feet. It continues the absorption process, mainly of vitamin B12, bile salts, and any remaining nutrients. At the end of the ileum, there is a valve called the ileocecal valve that prevents backflow of contents from the large intestine into the small intestine.
The primary function of the small intestine is to absorb the majority of nutrients, electrolytes, and water from ingested food. The mucosal lining of the small intestine contains numerous goblet cells that secrete mucus, which protects the epithelial surface and facilitates the movement of chyme through peristalsis. Additionally, the small intestine hosts a diverse community of microbiota, which contributes to various physiological functions, including digestion, immunity, and protection against pathogens.
Enteritis is a medical term that refers to inflammation of the small intestine. The small intestine is responsible for digesting and absorbing nutrients from food, so inflammation in this area can interfere with these processes and lead to symptoms such as diarrhea, abdominal pain, nausea, vomiting, and weight loss.
Enteritis can be caused by a variety of factors, including bacterial or viral infections, parasites, autoimmune disorders, medications, and exposure to toxins. In some cases, the cause of enteritis may be unknown. Treatment for enteritis depends on the underlying cause, but may include antibiotics, antiparasitic drugs, anti-inflammatory medications, or supportive care such as fluid replacement therapy.
Erythritol is a type of sugar alcohol (a carbohydrate that is metabolized differently than other sugars) used as a sugar substitute in food and drinks. It has about 0.24 calories per gram and contains almost no carbohydrates or sugar, making it a popular choice for people with diabetes or those following low-carb diets. Erythritol is naturally found in some fruits and fermented foods, but most commercial erythritol is made from cornstarch. It has a sweet taste similar to sugar but contains fewer calories and does not raise blood sugar levels.
Sphingomonas is a genus of gram-negative, aerobic bacteria that are widely distributed in the environment. They are known for their ability to degrade various organic compounds and are often found in water, soil, and air samples. The cells of Sphingomonas species are typically straight or slightly curved rods, and they do not form spores.
One distinctive feature of Sphingomonas species is the presence of a unique lipid called sphingolipid in their cell membranes. This lipid contains a long-chain base called sphingosine, which is not found in the cell membranes of other gram-negative bacteria. The genus Sphingomonas includes several species that have been associated with human infections, particularly in immunocompromised individuals. These infections can include bacteremia, pneumonia, and urinary tract infections. However, Sphingomonas species are generally considered to be of low virulence and are not typically regarded as major pathogens.
The duodenum is the first part of the small intestine, immediately following the stomach. It is a C-shaped structure that is about 10-12 inches long and is responsible for continuing the digestion process that begins in the stomach. The duodenum receives partially digested food from the stomach through the pyloric valve and mixes it with digestive enzymes and bile produced by the pancreas and liver, respectively. These enzymes help break down proteins, fats, and carbohydrates into smaller molecules, allowing for efficient absorption in the remaining sections of the small intestine.