- [Oxalate nephropathy due to malabsorption syndrome]. [Journal Article]
- NTNed Tijdschr Geneeskd 2018 Aug 23; 162
- Enteric oxalate nephropathy is caused by hyperoxaluria. Factors which contribute to excessive oxalate absorption are an abundance of free fatty acids in the intestine due to malabsorption, changes in...
Enteric oxalate nephropathy is caused by hyperoxaluria. Factors which contribute to excessive oxalate absorption are an abundance of free fatty acids in the intestine due to malabsorption, changes in the microbiome, and bowel inflammation. We present two cases that illustrate different pathophysiological aspects of this disease. The first patient was a 70-year-old male who developed oxalate nephropathy through malabsorption caused by chronic pancreatitis. It is plausible that the oxalate nephropathy was set off by antibiotic treatment which influenced the microbiome. The second patient was a 63-year-old male who underwent a Roux-en-Y gastric bypass. The associated malabsorption resulted in oxalate nephropathy. Kidney biopsies from both patients showed typical oxalate crystals. Therapeutic regimens using calcium supplementation, steroids, and a low oxalate diet are rational treatments, which have proven to prevent deterioration of renal function in some patients.
- Postprandial bile acid levels in intestine and plasma reveal altered biliary circulation in chronic pancreatitis patients. [Journal Article]
- JLJ Lipid Res 2018 Sep 11
- Bile acid (BA) secretion and circulation in chronic pancreatitis (CP) patients with exocrine pancreatic insufficiency (EPI) were investigated by measuring simultaneously postprandial levels of indivi...
Bile acid (BA) secretion and circulation in chronic pancreatitis (CP) patients with exocrine pancreatic insufficiency (EPI) were investigated by measuring simultaneously postprandial levels of individual BAs in duodenal contents and blood plasma using LC-MS/MS. CP patients and healthy volunteers (HV) were intubated with gastric and duodenal tubes prior to the administration of a test meal and continuous aspiration of duodenal contents. Pancreatic lipase outputs in CP patients were very low (0.7±0.2 mg) vs. HV (116.7±68.1 mg; P<0.005), thus confirming the severity of EPI. Duodenal BA outputs were reduced in CP patients (1.00±0.89 mmoles; 0.47±0.42 g) vs. HV (5.52±4.53 mmoles; 2.62±2.14 g; P<0.15). Primary to secondary BA ratio was considerably higher in CP patients (38.09±48.1) than HV (4.15±2.37; P<0.15), indicating an impaired transformation of BAs by gut microbiota. BA concentrations were found below the critical micellar concentration in CP patients, while a high BA concentration peak corresponding to gallblader emptying was evidenced in HV. Conversely, BA plasma concentration was increased in CP patients vs. HV suggesting a cholangiohepatic shunt of BA secretion. Alterations of BA circulation and levels may result from the main biliary duct stenosis observed in these CP patients. They may aggravate the consequences of EPI on lipid malabsorption.
- [Severe hypomagnesaemia due to proton pump inhibitor use]. [Journal Article]
- NTNed Tijdschr Geneeskd 2018 Aug 03; 162
- CONCLUSIONS: Hypomagnesaemia is a potentially serious adverse effect of PPIs. Serum magnesium levels should be monitored in chronic PPI-users with any neuromuscular, cardiovascular or non-specific symptoms, especially in the presence of known risk factors (alcohol use, malnutrition, malabsorption, hypertension and concomitant use of diuretics).
- The Predictive Value of the Hydrogen Breath Test in the Diagnosis of Fructose Malabsorption. [Journal Article]
- DDigestion 2018 Sep 04; :1-8
- CONCLUSIONS: The H2 breath test produced no predictive value for the fructose-free diet outcomes; its value as a predictive test is therefore questionable. However, the symptoms of fructose malabsorption correlated significantly with the H2 breath test measures, and this is an indication that there is at least a degree of validity of the H2 breath test beyond the simple detection or exclusion of fructose malabsorption.
- [Olmesartan therapy and enteropathy: About two cases and review of the literature]. [Journal Article]
- RMRev Med Interne 2018 Aug 30
- CONCLUSIONS: Our case reports underscore that accurate questioning is crucial in diagnostic approach, allowing to make the diagnosis of sprue-like enteropathy related to olmesartan in our patients. Interestingly, particular attention has recently been drawn to the fact that sprue-like disease may be a class effect of angiotensin II receptor blockers; further investigations are warranted to confirm these latter data.
- Long-Term Gastrointestinal Consequences are Frequent Following Sporadic Acute Infectious Diarrhea in a Tropical Country: A Prospective Cohort Study. [Journal Article]
- AJAm J Gastroenterol 2018 Aug 31
- CONCLUSIONS: FGIDs are common after AG; dyspeptic symptoms, CBD, and weight loss were risk factors for PI-FGIDs. Vibrio cholerae infection caused PI-FGID, which was never reported. About 9 % patients fulfilling the criteria for PI-IBS had PI-MAS.
- Can treatment of malabsorption in Shwachman-Diamond syndrome improve prognosis? [Editorial]
- PIPediatr Int 2018; 60(8):683
- Recent insights into the role of ChREBP in intestinal fructose absorption and metabolism. [News]
- BRBMB Rep 2018 Aug 30
- Fructose in the form of sucrose and high fructose corn syrup is absorbed by the intestinal transporter and mainly metabolized in the small intestine. However, excess intake of fructose overwhelms the...
Fructose in the form of sucrose and high fructose corn syrup is absorbed by the intestinal transporter and mainly metabolized in the small intestine. However, excess intake of fructose overwhelms the absorptive capacity of the small intestine, leading to fructose malabsorption. Carbohydrate response element-binding protein (ChREBP) is a basic helix-loop-helix leucine zipper transcription factor that plays a key role in glycolytic and lipogenic gene expression in response to carbohydrate consumption. While ChREBP was initially identified as a glucose-responsive factor in the liver, recent evidence suggests that ChREBP is essential for fructose-induced lipogenesis and gluconeogenesis in the small intestine as well as in the liver. We recently identified that the loss of ChREBP leads to fructose intolerance via insufficient induction of genes involved in fructose transport and metabolism in the intestine. As fructose consumption is increasing and closely associated with metabolic and gastrointestinal diseases, a comprehensive understanding of cellular fructose sensing and metabolism via ChREBP may uncover new therapeutic opportunities. In this mini review, we briefly summarize recent progress in intestinal fructose metabolism, the regulation and function of ChREBP by fructose, and delineate the potential mechanisms by which excessive fructose consumption may lead to irritable bowel syndrome.
- Application of a commercial digestive supplement formulated with enzymes and probiotics in lactase non-persistence management. [Journal Article]
- FFFood Funct 2018 Aug 29
- Strategies to avoid lactose malabsorption, which affects 70% of the world's population, are focused on the restriction of milk and dairy products or the use of non-human β-galactosidases or probiotic...
Strategies to avoid lactose malabsorption, which affects 70% of the world's population, are focused on the restriction of milk and dairy products or the use of non-human β-galactosidases or probiotics endowed with β-galactosidase activity added at mealtime. Our evaluation of a commercial blend of probiotics and enzymes (protease, lactase, lipase and amylase) and its potential application in lactase non-persistence management is described in this work. Recommended amounts (460-1000 mg) of the commercial probiotics-enzyme blend were shown to be adequate for performing in vitro lactose hydrolysis in standard solutions (0.25-5%) and commercial dairy products, namely milks (5% lactose) and yogurts (3% lactose), reaching hydrolysis values between 44 and 96%. According to these percentages, the use of the enzymatic preparation would guarantee the intake of less than 12 g, the recommendation of the EFSA for lactose intolerance. Furthermore, formation of prebiotic galactooligosaccharides was also detected, increasing the potential benefits of the enzymatic preparation in the gastrointestinal system.
New Search Next
- Intravenous Irons: From Basic Science to Clinical Practice. [Review]
- PPharmaceuticals (Basel) 2018 Aug 27; 11(3)
- Iron is an essential trace mineral necessary for life, and iron deficiency anaemia (IDA) is one of the most common haematological problems worldwide, affecting a sixth of the global population. Princ...
Iron is an essential trace mineral necessary for life, and iron deficiency anaemia (IDA) is one of the most common haematological problems worldwide, affecting a sixth of the global population. Principally linked to poverty, malnutrition and infection in developing countries, in Western countries the pathophysiology of IDA is primarily linked to blood loss, malabsorption and chronic disease. Oral iron replacement therapy is a simple, inexpensive treatment, but is limited by gastrointestinal side effects that are not inconsequential to some patients and are of minimal efficacy in others. Third generation intravenous (IV) iron therapies allow rapid and complete replacement dosing without the toxicity issues inherent with older iron preparations. Their characteristic, strongly-bound iron-carbohydrate complexes exist as colloidal suspensions of iron oxide nanoparticles with a polynuclear Fe(III)-oxyhydroxide/oxide core surrounded by a carbohydrate ligand. The physicochemical differences between the IV irons include mineral composition, crystalline structure, conformation, size and molecular weight, but the most important difference is the carbohydrate ligand, which influences complex stability, iron release and immunogenicity, and which is a unique feature of each drug. Recent studies have highlighted different adverse event profiles associated with third-generation IV irons that reflect their different structures. The increasing clinical evidence base has allayed safety concerns linked to older IV irons and widened their clinical use. This review considers the properties of the different IV irons, and how differences might impact current and future clinical practice.