vitamin-b-12 and Diarrhea

Topics: Bacterial Infections; Bile Acids and Salts; Carbohydrates; Diarrhea; Humans; Intestinal Absorption; Intestinal Diseases; Intestine, Small; Lipid Metabolism; Proteins; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Abetalipoproteinemia; Acrodermatitis; Acute Disease; Age Factors; Amino Acid Metabolism, Inborn Errors; Animals; Celiac Disease; Child; Chlorides; Cystic Fibrosis; Diarrhea; Diet Therapy; Endopeptidases; Enteritis; Food Hypersensitivity; Humans; Lactose Intolerance; Malabsorption Syndromes; Metabolism, Inborn Errors; Milk; Vitamin B 12

Topics: Bile Acids and Salts; Diarrhea; Dietary Proteins; Humans; Ileum; Intestinal Absorption; Jejunum; Methods; Obesity; Time Factors; Vitamin B 12

Topics: Antigens, Bacterial; Antilymphocyte Serum; Bile Acids and Salts; Celiac Disease; Chronic Disease; Colectomy; Colitis, Ulcerative; Crohn Disease; Cytotoxicity Tests, Immunologic; Diarrhea; Digestive System; Escherichia coli; Gastrointestinal Hemorrhage; Glutens; Humans; Ileostomy; Immune Sera; Lymphocytes; Malabsorption Syndromes; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Age Factors; Animals; Child; Child, Preschool; Diarrhea; Disease Outbreaks; Feces; Female; Folic Acid; Humans; Intestinal Absorption; Intestinal Mucosa; Intestinal Neoplasms; Lipid Metabolism; Lymphoma; Male; Sprue, Tropical; Tritium; Vitamin B 12

Topics: Bacteria; Bacteroides; Diabetes Mellitus; Diarrhea; Dietary Carbohydrates; Dietary Fats; Duodenum; Dysentery, Bacillary; Enterobacteriaceae; Escherichia coli; Feces; Gastrointestinal Motility; Humans; Ileum; Intestinal Absorption; Intestinal Diseases; Intestines; Jejunum; Lactobacillus; Postgastrectomy Syndromes; Scleroderma, Systemic; Sprue, Tropical; Stomach; Vibrio; Vitamin B 12; Water-Electrolyte Balance

Topics: Anemia; Anemia, Macrocytic; Celiac Disease; Diagnosis; Diarrhea; Humans; Intestinal Obstruction; Intestine, Small; Intestines; Physiology; Vitamin B 12

Patients with small intestinal neuroendocrine tumours (SI-NET) often have diarrhoea from hormonal overproduction, surgery and medical treatment, leading to malabsorption of bile salts, fats, vitamin B12 and fat-souble vitamins. This could lead to malnutrition.. We assessed nutritional status in 50 consecutive out patients with disseminated SI-NET, 25 patients in each cohort. The first cohort was descriptive and the second cohort supplemented with vitamin D, B12 and calcium. Vitamin D deficiency was defined as <50 nmol/l. All patients were assessed by clinical chemistry and dual-energy X-ray absorptiometry (DXA) and interviewed about weight changes, appetite, gastrointestinal disorders, sunhabits and the use of supplements.. In the first cohort, 29% of the patients were severely and 17% moderately vitamin D deficient. In patients without prior substitution, 32% had subnormal vitamin B12 levels. Seventy-six percent had low bone density. In the second cohort with vitamin and mineral supplementation, none had severe vitamin D deficiency, but 28% had moderate deficiency. No patient had subnormal vitamin B12 levels. Sixty percent had low bone density. The serum levels of vitamin D and B12 were higher and parathyroid hormone (PTH) lower in the second cohort compared with the first cohort (P⩽0,022). Vitamin D and PTH were negatively correlated, r=-30, P=⩽0.036.. Low serum levels of vitamin D and vitamin B12, and low bone density are common in patients with disseminated SI-NET. Supplementation of vitamin D, B12 and calcium resulted in higher serum levels of vitamins, lower PTH levels and diminished severe vitamin D deficiency and is thus recommended as standard care.

Topics: Absorptiometry, Photon; Aged; Aged, 80 and over; Bone Density; Carcinoid Tumor; Diarrhea; Dietary Supplements; Female; Humans; Intestinal Absorption; Intestinal Neoplasms; Intestine, Small; Male; Middle Aged; Nutritional Status; Parathyroid Hormone; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin D; Vitamin D Deficiency; Vitamins

Haiti has experienced rapid urbanization that has exacerbated poverty and undernutrition in large slum areas. Stunting affects 1 in 5 young children.. We aimed to test the efficacy of a daily lipid-based nutrient supplement (LNS) for increased linear growth in young children.. Healthy, singleton infants aged 6-11 mo (n = 589) were recruited from an urban slum of Cap Haitien and randomly assigned to receive: 1) a control; 2) a 3-mo LNS; or 3) a 6-mo LNS. The LNS provided 108 kcal and other nutrients including vitamin A, vitamin B-12, iron, and zinc at ≥80% of the recommended amounts. Infants were followed monthly on growth, morbidity, and developmental outcomes over a 6-mo intervention period and at one additional time point 6 mo postintervention to assess sustained effects. The Bonferroni multiple comparisons test was applied, and generalized least-squares (GLS) regressions with mixed effects was used to examine impacts longitudinally.. Baseline characteristics did not differ by trial arm except for a higher mean age in the 6-mo LNS group. GLS modeling showed LNS supplementation for 6 mo significantly increased the length-for-age z score (±SE) by 0.13 ± 0.05 and the weight-for-age z score by 0.12 ± 0.02 compared with in the control group after adjustment for child age (P < 0.001). The effects were sustained 6 mo postintervention. Morbidity and developmental outcomes did not differ by trial arm.. A low-energy, fortified product improved the linear growth of young children in this urban setting. The trial was registered at clinicaltrials.gov as NCT01552512.

Topics: Body Weight; Child Development; Diarrhea; Dietary Supplements; Energy Intake; Follow-Up Studies; Haiti; Humans; Infant; Infant Nutritional Physiological Phenomena; Iron, Dietary; Longitudinal Studies; Morbidity; Poverty Areas; Respiratory Tract Infections; Socioeconomic Factors; Urban Population; Vitamin A; Vitamin B 12; Zinc

Young children in low- and middle-income countries frequently have inadequate vitamin B-12 (cobalamin) status. Poor folate status is also common and is associated with increased diarrheal and respiratory morbidity.. The objective was to measure the effect of folic acid and/or vitamin B-12 administration on the incidence of diarrhea and acute lower respiratory tract infections.. One thousand North Indian children (6-30 mo of age) were enrolled in a randomized, double-blind, placebo-controlled trial to receive 2 times the Recommended Dietary Allowance of folic acid and/or vitamin B-12 or placebo daily for 6 mo. Children were individually randomly assigned in a 1:1:1:1 ratio in blocks of 16. Primary outcomes were the number of episodes of acute lower respiratory infections, diarrhea, and prolonged diarrhea.. Folic acid and vitamin B-12 supplementation significantly improved vitamin B-12 and folate status, respectively. Neither folic acid nor vitamin B-12 administration reduced the incidence of diarrhea or lower respiratory infections. In comparison with placebo, children treated with folic acid alone or in combination with vitamin B-12 had a significantly higher risk of persistent diarrhea (OR: 2.1; 95% CI: 1.1, 3.8).. Folic acid or vitamin B-12 supplementation did not reduce the burden of common childhood infections. In view of the increased risk of diarrhea, the safety of folic acid supplements in young children should be further assessed. This trial was registered at www.clinicaltrials.gov as NCT00717730 and at www.ctri.nic.in as CTRI/2010/091/001090.

Topics: Child, Preschool; Diarrhea; Dietary Supplements; Double-Blind Method; Female; Folic Acid; Folic Acid Deficiency; Humans; India; Infant; Male; Nutrition Policy; Odds Ratio; Respiratory Tract Infections; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B Complex; Vitamin B Deficiency

The observed effect of zinc supplementation on diarrheal morbidity varies between trials and there is a need to identify subgroups most likely to benefit from improved zinc nutriture. In a randomized, double-blind trial in 2296 children in New Delhi, India, we assessed whether baseline cobalamin or folate status modified the effect of zinc supplementation on the incidence of prolonged (≥ 7 d duration) and acute diarrhea. Children aged 6-30 mo received zinc or placebo daily for 4 mo. We measured plasma concentrations of folate, cobalamin, total homocysteine (tHcy), and methylmalonic acid (MMA) at enrollment and assessed the efficacy of zinc supplementation in subgroups based on these variables. The efficacy of zinc on reducing the risk of prolonged diarrhea was higher in those with plasma cobalamin concentrations below the 25th percentile and in those with tHcy and MMA concentrations above the 75th percentile. The OR (95% CI) for children below and above the 25th percentile for cobalamin were 0.53 (0.35-0.78) and 0.90 (0.73-1.11), respectively (P-interaction = 0.015). There were similar differences for the OR when comparing efficacy in those above and below the 75th percentile for tHcy and MMA (P-interaction = 0.045 and 0.188, respectively). Baseline folate status did not modify the effect of zinc on prolonged diarrhea. Neither cobalamin nor folate status influenced the effect of zinc on acute diarrhea. Children with poor cobalamin status benefited more from zinc supplementation for the prevention of prolonged diarrhea.

Topics: Child, Preschool; Diarrhea; Dietary Supplements; Female; Folic Acid; Homocysteine; Humans; Incidence; India; Infant; Male; Methylmalonic Acid; Vitamin B 12; Zinc

Poor micronutrient status is associated with diarrheal illness, but it is not known whether low folate and/or cobalamin status are independent risk factors for diarrhea. We measured the association between plasma folate and cobalamin and subsequent diarrheal morbidity in a prospective cohort study of 2296 children aged 6-30 mo in New Delhi, India. Plasma concentrations of folate, cobalamin, total homocysteine (tHcy), and methylmalonic acid were determined at baseline. Whether a child had diarrhea was recorded during weekly visits in a 4-mo zinc supplementation trial. Diarrhea episodes lasting <7, ≥7, and ≥14 d were classified as acute, prolonged, and persistent, respectively. There was a total of 4596 child periods with acute, 633 with prolonged, and 117 with persistent diarrhea during follow-up. Children with plasma folate concentrations in the lowest quartile had higher odds of persistent diarrhea than children in the other quartiles [adjusted OR = 1.77 (95% CI = 1.14, 2.75); P = 0.01]. This effect differed between boys [adjusted OR = 2.51 (95% CI = 1.47, 4.28)] and girls [adjusted OR = 1.03 (95% CI = 0.53, 2.01); P-interaction = 0.030]. We found a small but significant association between high plasma tHcy concentration and acute diarrhea [adjusted OR = 1.14 (95% CI = 1.04, 1.24); P = 0.006]. Plasma cobalamin concentration was not a predictor of diarrheal morbidity. In conclusion, poor folate status was an independent predictor of persistent diarrhea in this population.

Topics: Biomarkers; Child, Preschool; Diarrhea; Female; Folic Acid; Folic Acid Deficiency; Follow-Up Studies; Homocysteine; Humans; India; Infant; Interviews as Topic; Male; Prospective Studies; Risk Factors; Treatment Outcome; Vitamin B 12

This phase I study was conducted to determine the toxicities, pharmacokinetics, and recommended doses of pemetrexed in cancer patients with normal and impaired renal function.. Patients received a 10-minute infusion of 150 to 600 mg/m2 of pemetrexed every 3 weeks. Patients were stratified for independent dose escalation by measured glomerular filtration rate (GFR) into four cohorts ranging from > or = 80 to less than 20 mL/min. Pemetrexed plasma and urine pharmacokinetics were evaluated for the first cycle. Patients enrolled after December 1999 were supplemented with oral folic acid and intramuscular vitamin B12.. Forty-seven patients were treated with 167 cycles of pemetrexed. Hematologic dose-limiting toxicities occurred in vitamin-supplemented patients (two; 15%) and non-supplemented patients (six; 18%), and included febrile neutropenia (four patients) and grade 4 thrombocytopenia (two patients). Nonhematologic toxicities included fatigue, diarrhea, and nausea, and did not correlate with renal function. Accrual was discontinued in patients with GFR less than 30 mL/min after one patient with a GFR of 19 mL/min died as a result of treatment-related toxicities. Pemetrexed plasma clearance positively correlated with GFR (r2 = 0.736), resulting in increased drug exposures in patients with impaired renal function. With vitamin supplementation, pemetrexed 600 mg/m2 was tolerated by patients with a GFR > or = 80 mL/min, whereas patients with a GFR of 40 to 79 mL/min tolerated a dose of 500 mg/m2.. Pemetrexed was well tolerated at doses of 500 mg/m2 with vitamin supplementation in patients with GFR > or = 40 mL/min. Additional studies are needed to define appropriate dosing for renally impaired patients receiving higher dose pemetrexed with vitamin supplementation.

Topics: Adult; Aged; Antimetabolites, Antineoplastic; Antineoplastic Combined Chemotherapy Protocols; Diarrhea; Drug Administration Schedule; Fatigue; Female; Folic Acid; Glutamates; Guanine; Humans; Kidney Failure, Chronic; Male; Middle Aged; Nausea; Neoplasms; Neutropenia; Pemetrexed; Thrombocytopenia; Vitamin B 12

Topics: Adolescent; Adult; Aged; Cholestyramine Resin; Clinical Trials as Topic; Colon; Diarrhea; Fats; Feces; Female; Humans; Ileum; Intestinal Absorption; Male; Middle Aged; Placebos; Postoperative Complications; Vitamin B 12

Type 1 diabetes mellitus (T1DM) is a lifelong diagnosis that involves immune-mediated damage of pancreatic beta cells and subsequent hyperglycemia, manifesting as: polyuria, polydipsia, polyphagia, and weight loss. Treatment of type 1 diabetes centers on insulin administration to replace or supplement the body's own insulin with the goal of achieving euglycemia and preventing or minimizing complications. Patients with T1DM are at risk for developing other autoimmune conditions, most commonly thyroid or celiac disease.. A 20-year-old African American female with T1DM was referred by her endocrinologist to pediatric gastroenterology for 2 months of nocturnal, non-bloody diarrhea, left lower quadrant pain, and nausea; she was also being followed by neurology for complaints of lower extremity paresthesias and pain. The patient's initial lab-workup was remarkable for a low total Immunoglobulin A (IgA) level of < 6.7 mg/dL. As IgA deficiency is associated with an increased risk of celiac disease, the patient underwent upper and lower endoscopy, which was grossly unremarkable; however, histology revealed a pattern consistent with autoimmune gastritis. Subsequent serum evaluation was remarkable for an elevated fasting gastrin level and an elevated parietal cell antibody level without macrocytic anemia, iron deficiency, or vitamin B12 depletion. The patient was diagnosed with autoimmune gastritis (AIG) and subsequently initiated on parenteral B12 supplementation therapy with improvement in her neurologic and gastrointestinal symptoms.. This case illustrates the importance of recognition of red flag findings in a patient with known autoimmune disease. Following well-established health maintenance recommendations for individuals with T1DM ensures that common comorbidities will be detected. Autoimmune gastritis, while a rarer pathology in the pediatric population, deserves consideration in patients with pre-existing autoimmune conditions and new gastrointestinal or neurologic symptoms, as AIG can be associated with poor outcomes and risk of malignancy. Initial lab findings associated with an eventual diagnosis of AIG typically include anemia, iron deficiency, or Vitamin B12 deficiency. However, as demonstrated in this case, symptoms of AIG can rarely present before anemia or Vitamin B12 deficiency develops. To prevent permanent neurological damage, parenteral Vitamin B12 therapy must be considered even in the absence of Vitamin B12 deficiency, especially in those patients already experiencing neurological symptoms.

Topics: Adult; Anemia, Iron-Deficiency; Autoimmune Diseases; Celiac Disease; Child; Diabetes Mellitus, Type 1; Diarrhea; Female; Gastritis; Humans; Insulins; Pain; Vitamin B 12; Vitamin B 12 Deficiency; Young Adult

A recent trial of vitamin B12 supplementation among Indian children 6-30 months found no effect on the incidence of diarrhea and respiratory infections. These results differ with studies in adults that showed improvement of the immune response following treatment with vitamin B12. We sought to determine how the adequacy of vitamin B12 concentrations in breast milk could act as immune modulator and protect against the incidence of diarrhea and respiratory infections of children up to 18 months in urban Tanzania.. A prospective cohort study was undertaken to determine the association of breast milk vitamin B12 concentration with the incidence of acute respiratory infection and diarrhea among infants in urban Tanzania. A random sample of 491 women enrolled in a trial of multivitamins provided milk for B12 analysis at or around 6 weeks postpartum. Of 491 women, 345 had breast milk vitamin B12 inadequacy (< 310 pmol/L). Using generalized estimating equations, we found no overall association of milk vitamin B12 concentration with incident diarrhea and acute respiratory infections in infants. Studies measuring longitudinal changes of breast milk B12 concentration over time are needed to clarify the role of breast milk vitamin B12 in childhood infections.

Topics: Acute Disease; Adolescent; Adult; Breast Feeding; Diarrhea; Female; Humans; Incidence; Infant; Lactation; Male; Milk, Human; Prospective Studies; Respiratory Tract Infections; Tanzania; Vitamin B 12; Young Adult

Topics: Diabetes Mellitus, Type 1; Diarrhea; Humans; Male; Metformin; Middle Aged; Vitamin B 12; Vitamin B 12 Deficiency

Recent studies have demonstrated a relationship between poor vitamin D status and respiratory infections and diarrhea among young children. Acute lower respiratory infections (ALRI) and diarrhea are among the two most important causes of death in under-5 children. In this paper, we examined the extent to which vitamin-D deficiency (<10 ng/ml) predicts ALRI, clinical pneumonia and diarrhea among 6 to 30 months old children.. We used data from a randomized controlled trial (RCT) of daily folic acid and/or vitamin B12 supplementation for six months in 6 to 30 months old children conducted in Delhi, India. Generalized estimating equations (GEE) were used to examine the associations between vitamin-D deficiency and episodes of ALRI, clinical pneumonia and diarrhea.. Of the 960 subjects who had vitamin-D concentrations measured, 331(34.5%) were vitamin-D deficient. We found, after controlling for relevant potential confounders (age, sex, breastfeeding status, wasting, stunting, underweight, anemia status and season), that the risk of ALRI was significantly higher among vitamin-D deficient (OR 1.26; 95% CI: 1.03 to 1.55) compared to vitamin-D-replete children in the six months follow-up period. Vitamin-D status was not associated with episodes of diarrhea or clinical pneumonia.. Vitamin-D deficiency is common in young children in New Delhi and is associated with a higher risk of ALRI. The role of vitamin D in Indian children needs to be elucidated in further studies.

Topics: Child, Preschool; Diarrhea; Dietary Supplements; Female; Folic Acid; Humans; India; Infant; Luminescent Measurements; Male; Odds Ratio; Pneumonia; Respiratory Tract Infections; Seasons; Social Class; Vitamin B 12; Vitamin D; Vitamin D Deficiency

Chronic diarrhea poses a significant threat to the health of NHP research colonies, and its primary etiology remains unclear. In macaques, the clinical presentation of intractable diarrhea and weight loss that are accompanied by inflammatory infiltrates within the gastrointestinal tract closely resembles inflammatory bowel disease of humans, dogs, and cats, in which low serum and tissue cobalamin (vitamin B12) levels are due to intestinal malabsorption. We therefore hypothesized that macaques with chronic idiopathic diarrhea (CID) have lower serum cobalamin concentrations than do healthy macaques. Here we measured serum cobalamin concentrations in both rhesus and pigtailed macaques with CID and compared them with those of healthy controls. Serum cobalamin levels were 2.5-fold lower in pigtailed macaques with CID than control animals but did not differ between rhesus macaques with CID and their controls. This finding supports the use of serum cobalamin concentration as an adjunct diagnostic tool in pigtailed macaques that present with clinical symptoms of chronic gastrointestinal disease. This use of serum vitamin B12 levels has implications for the future use of parenteral cobalamin supplementation to improve clinical outcomes in this species.

Topics: Animals; Case-Control Studies; Chronic Disease; Diarrhea; Female; Humans; Inflammatory Bowel Diseases; Macaca mulatta; Macaca nemestrina; Male; Monkey Diseases; Reference Values; Species Specificity; Vitamin B 12

Administration of vitamin B12 and folic acid for 7 days prior to the administration of the first dose of pemetrexed is recommended. However, vitamin supplementation rarely is initiated less than 7 days prior to the first dose of pemetrexed. Therefore, we analyzed the safety of pemetrexed with vitamin supplementation for less than 7 days prior to the first dose of pemetrexed.. Patients were classified into 2 groups according to the duration of vitamin supplementation prior to the first dose of pemetrexed: group A received vitamin supplementation for 7 days or more, and group B received vitamin supplementation for less than 7 days. We analyzed adverse effects, such as myelosuppression, rash, and diarrhea, after 1 cycle of pemetrexed therapy.. A total of 70 patients were administered pemetrexed; 40 patients were men and 30 were women with a median age of 64.5 years(range, 43-86 years). A total of 57 patients were classified into group A and 13 into group B; 33 patients were administered pemetrexed as a first-line treatment. Neutropenia of Grade 3 or more was observed in 4/49(8.2%)patients in group A and 2/13(15.4%)patients in group B(p=0.60). There were no significant differences in the rates of occurrence of neutropenia, rash, and diarrhea.. This retrospective study indicated that patients could be safely treated with pemetrexed if vitamin supplementation is initiated for less than 7 days prior to the first administration of pemetrexed. However, further studies are needed because of a lack of statistical power and adjustment for confounding factors.

Topics: Adult; Aged; Aged, 80 and over; Antimetabolites, Antineoplastic; Carcinoma, Non-Small-Cell Lung; Diarrhea; Dietary Supplements; Drug Combinations; Exanthema; Female; Folic Acid; Glutamates; Guanine; Humans; Lung Neoplasms; Male; Middle Aged; Neutropenia; Pemetrexed; Retrospective Studies; Vitamin B 12

Cobalamin and folate are essential micronutrients and are important in DNA and RNA synthesis, cell proliferation, growth, hematopoiesis, and cognitive function. However, data on cobalamin and folate status are lacking particularly from young children residing in low and middle income countries.. To measure cobalamin and folate status and identifies their predictors among 6 to 35 months old children presenting with acute diarrhea.. This was a cross-sectional study in 823 children presenting with acute diarrhea. We measured plasma cobalamin, folate, methylmalonic acid and total homocysteine who sought treatment for acute diarrhea between June 1998 and August 2000.. The mean (SD) plasma concentrations of cobalamin, folate, total homocysteine and methylmalonic acid were 206 (124) pmol/L, 55 (32) nmol/L, 11.4 (5.6) µmol/L and 0.79 (1.2) µmol/L, respectively. The prevalence of low plasma cobalamin (<150 pmol/L) was 41% but less than 2% (15) children had low folate concentration (<10 nmol/L). Plasma homocysteine and methylmalonic acid concentrations were negatively associated with cobalamin concentration but not associated with folate status. The prevalence of cobalamin deficiency was higher in breastfed than non-breastfed children (44% vs 24%; p = <0.001). The prevalence of hyperhomocysteinemia (>10 µmol/L) and elevated methylmalonic acid (>0.28 µmol/L) were 73% and 52%, respectively. In the regression analyses, the plasma cobalamin concentration was positively associated with age, and introduction of animal or formula milk.. Our study indicated that poor cobalamin status was common particularly among breastfed children. Folate deficiency was virtually none existent. Possible consequences of cobalamin deficiency in young children need to be explored.

Topics: Acute Disease; Child, Preschool; Cross-Sectional Studies; Diarrhea; Female; Folic Acid; Humans; Infant; Male; Nepal; Vitamin B 12

To investigate the feasibility and the effectiveness of ileoileostomy in the region adjacent to the ileocecal valve, which can retain the ileocecal valve in infants.. This is a retrospective review of 48 patients who underwent ileoileostomy in the region adjacent to the ileocecal valve (group 1) and 34 patients who underwent ileocecal resections and ileotransversanastomosis (group 2). Patients were monitored for the time to flatus, resumption of eating, length of hospital stay after surgery, serum total bile acid, vitamin B12 and postoperative complications.. The time to flatus, time until resumption of eating and post-operative length of hospital stay showed no statistically significant differences between the two groups. Serum total bile acid and vitamin B12 were not significantly different between the two groups at post-operative day 1 and day 3, but were significantly decreased at 1 wk after operation in group 2. None of the patients died or suffered from stomal leak in these two groups. However, the incidence of diarrhea, intestinal infection, disturbance of acid-base balance and water-electrolytes in group 1 was lower than in group 2.. Ileoileostomy in the region adjacent to the ileocecal valve is safe and results in fewer complications than ileotransversanastomosis in infants.

Topics: Anastomosis, Surgical; Bile Acids and Salts; Colectomy; Diarrhea; Digestive System Surgical Procedures; Female; Humans; Ileocecal Valve; Infant; Infant, Newborn; Intestines; Length of Stay; Male; Postoperative Complications; Retrospective Studies; Treatment Outcome; Vitamin B 12

The role of gastrointestinal infection as a factor determining vitamin B12 status in populations with low intake of animal-source foods is unclear.. To determine dietary adequacy and serum concentrations of vitamin B12 in an extremely impoverished indigenous population of Panamanian children aged 12 to 60 months, and to identify predictors of both dietary and serum vitamin B12.. A previous community-based survey provided the usual dietary intake and personal, household, and infection (Ascaris and diarrheal disease) information for 209 weaned children. Serum vitamin B12 was assayed using electrochemiluminescence for 65 of these children. Children with adequate or inadequate dietary vitamin B12 intake were compared, and predictors of dietary and serum vitamin B12 were identified using stepwise regression analyses of one index child per household.. Dietary vitamin B12 intake was inadequate in 43% of children; these children were poorer, had less frequent diarrhea, and obtained a higher percentage of their energy from carbohydrate than children with adequate intake. Energy intake positively predicted dietary vitamin B12 intake. In contrast, serum vitamin B12 concentrations were normal in all but 3% of the children. Serum vitamin B12 was positively associated with weekly servings of fruit, corn-based food, and name (a traditional starchy food), but not with animal-source foods. Finally, serum vitamin B12 was not associated with Ascaris intensity but was lowered with increasing frequency of diarrhea.. Although inadequate dietary intake of vitamin B12 was common, most serum values were normal. Nevertheless, diarrheal disease emerged as a negative predictor of serum vitamin B12 concentration.

Topics: Ascariasis; Child, Preschool; Diarrhea; Diarrhea, Infantile; Diet; Energy Intake; Family Characteristics; Humans; Indians, Central American; Infant; Nutrition Surveys; Nutritional Status; Panama; Poverty; Prevalence; Risk Factors; Severity of Illness Index; Vitamin B 12; Vitamin B 12 Deficiency

Medical records of 16 cats diagnosed with exocrine pancreatic insufficiency (EPI) were reviewed. The diagnosis was confirmed with either a serum feline trypsin-like immunoreactivity (fTLI) concentration

Topics: Anemia; Animals; Cat Diseases; Cats; Diarrhea; Exocrine Pancreatic Insufficiency; Female; Lymphopenia; Male; Treatment Outcome; Vitamin B 12; Weight Loss

A 57-year-old Dutch man presented with weight loss and fatigue 6 months after a visit to West Papua, when he had suffered from serious diarrhoea. Macrocytic anaemia and vitamin B12 deficiency were diagnosed. A gastroduodenoscopy with biopsies of the small intestine was performed revealing no macroscopic abnormalities but partial villous atrophy was found microscopically, suggesting tropical sprue or coeliac disease. Antibodies against endomysium and tissue transglutaminase were negative, ruling out coeliac disease. The patient was successfully treated with vitamin B12, folic acid and doxycycline. This case shows that tropical sprue should be considered in the differential diagnosis of chronic diarrhoea in patients with a history of travel in tropical regions. The most frequent medical problem that travelers to the tropics experience is diarrhoea with an incidence of 30%. A small proportion of these patients eventually present with chronic diarrhoea. At that moment, the relation to their previous travelling may not be immediately clear. One of the causes of this chronic diarrhoea to be considered is tropical sprue.

Topics: Celiac Disease; Diagnosis, Differential; Diarrhea; Doxycycline; Humans; Male; Middle Aged; Papua New Guinea; Sprue, Tropical; Travel; Treatment Outcome; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B Complex

The aim of the study was to investigate whether pelvic radiotherapy for rectal cancer had a negative impact on cobalamin status.. Consecutive patients receiving pelvic radiotherapy (50 Gy) for rectal cancer were evaluated prospectively (n = 54). Serum cobalamin, holotranscobalamin (holoTC), methylmalonic acid (MMA), and total homocysteine (tHcy) were measured at start and end of radiotherapy, at follow-up 4-6 weeks and 1 year (n = 23) after radiotherapy.. Mean serum cobalamin decreased from 306 pmol/L before treatment to 267 pmol/L at the end of radiotherapy (p < 0.001), 247 pmol/L 4-6 weeks after radiotherapy (p < 0.001), and 249 pmol/L 1 year after radiotherapy (p = 0.02). Mean serum MMA was 0.16 micromol/L pretreatment, 0.17 micromol/L at the end of radiotherapy (n.s.), and increased to 0.19 micromol/L after 4-6 weeks (p = 0.007), and to 0.21 micromol/L after 1 year (p < 0.001). There was no change in serum tHcy. Mean serum holoTC was reduced from 111 pmol/L pretreatment to 93 pmol/L 4-6 weeks after radiotherapy (p = 0.002).. The data suggest rapid and persistent decrease in cobalamin status after radiotherapy for rectal cancer, as reflected by reduced serum cobalamin combined with increased serum MMA. This observation, though modest, may motivate routine monitoring of cobalamin status at follow-up after radiotherapy.

Topics: Adult; Aged; Biomarkers; Diarrhea; Female; Homocystine; Humans; Male; Methylmalonic Acid; Middle Aged; Rectal Neoplasms; Transcobalamins; Vitamin B 12; Vitamin B 12 Deficiency

To define the clinical syndrome, nutritional status and malabsorptive status in patients with HIV and chronic diarrhea and either microsporidia or no identified pathogen.. HIV-positive patients from an urban, hospital-based infectious disease clinic with chronic diarrhea who had undergone exhaustive gastrointestinal and stool studies for enteric pathogens and were found to have either microsporidia or no pathogen.. Patients were evaluated for clinical history, physical, body composition, nutritional and malabsorptive studies including D-xylose, Schilling test, determinations of 24 h stool fat, weight and nitrogen, and 24 h urea nitrogen.. Ten patients with microsporidia were studied, four of whom were infected with Septata intestinalis, six with Enterocytozoon bieneusi; nine patients had no identified pathogen. Patients in both groups were comparable in stage of HIV disease, and demonstrated abnormal nutritional status and malabsorptive parameters. Patients with no pathogen had significantly longer duration of symptoms prior to presentation; however, patients with microsporidia had significantly greater malabsorption of fat, D-xylose, vitamin B12, and significantly lower serum levels of zinc. Nutritional status and malabsorption were similarly depressed in patients infected with either species of microsporidia.. HIV-infected patients with chronic diarrhea associated with either microsporidial infection or with no identified pathogen had abnormal parameters of absorption and malnutrition, and those infected with microsporidia demonstrated more severe malabsorption.

Topics: Acquired Immunodeficiency Syndrome; Adult; Animals; CD4 Lymphocyte Count; Diarrhea; Dietary Fats; HIV Wasting Syndrome; Humans; Malabsorption Syndromes; Male; Microsporida; Protozoan Infections; Vitamin B 12; Xylose; Zinc

This study examines small intestinal absorption-permeability, intestinal inflammation and ileal structure and function in HIV-positive male homosexuals.. Thirty HIV-seropositive male homosexuals at various stages of disease underwent intestinal absorption permeability and 111indium leukocyte studies (for quantification of intestinal inflammation). Twenty-six men with AIDS had a dual radioisotopic ileal function test (whole body retention of tauro 23-[75Se]-selena 25-homocholic acid and 58cobalt-labelled cyanocobalamine), and 17 underwent ileocolonoscopy with terminal ileal biopsy.. Well, HIV-infected, subjects had normal intestinal absorption-permeability, but both functions were impaired upon the development of AIDS. The median faecal excretion of 111indium in well patients (0.66%) did not differ significantly (P > 0.5) from controls (0.46%), but subjects with AIDS who were well or who had diarrhoea had significant (P < 0.005) intestinal inflammation (1.33% and 2.18%, respectively). The median 7-day retention of tauro 23-[75Se]-selena 25-homocholic acid in well patients with AIDS (38.9%) did not differ significantly (P > 0.2) from controls (39.3%), whereas the absorption of 58cobalt-labelled cyanocobalamine was significantly (P < 0.05) lower than controls (32.1% and 59.4%). Patients with AIDS-diarrhoea had significant (P < 0.001) malabsorption of both the bile acid (7.7%) and vitamin B12 (8.9%) which was more severe than in Crohn's ileitis (14.2% and 30.3%, respectively). Morphometric analyses of ileal biopsies were unremarkable in AIDS.. These studies demonstrate a low-grade enteropathy in patients with AIDS, severe ileal malabsorption in patients with AIDS diarrhoea and relatively minor ileal morphologic changes. Malabsorption of bile acids may play a pathogenic role in patients with AIDS and diarrhoea.

Topics: Acquired Immunodeficiency Syndrome; Adult; CD4 Lymphocyte Count; Crohn Disease; Diarrhea; HIV Seropositivity; Humans; Ileum; Inflammatory Bowel Diseases; Intestinal Absorption; Male; Middle Aged; Vitamin B 12

Topics: Autoantibodies; Celiac Disease; Chronic Disease; Diarrhea; Folic Acid; Humans; Vitamin B 12

Small intestinal bacterial overgrowth (SIBO) was diagnosed by quantitative bacterial culture of duodenal juice samples obtained endoscopically in 41 of 80 dogs that were admitted with chronic diarrhea, vomiting, or weight loss. Thirteen dogs had aerobic bacterial overgrowth, most frequently comprising Escherichia coli, staphylococci, and enterococci, and 28 dogs had mixed anaerobic overgrowth, most frequently including Clostridium and Bacteroides spp. Affected dogs comprised 23 breeds, including 10 German Shepherd Dogs and median age at diagnosis was 2 years (range, 6 months to 11 years). High serum folate and low serum cobalamin concentrations had fair specificity (79 and 87%, respectively), but low sensitivity (51 and 24%, respectively) in detecting SIBO. Histologic examination of duodenal biopsy specimens did not reveal abnormalities (26/41 dogs), or revealed mild to moderate lymphocytic (12/41) or eosinophilic (2/41) infiltrates, or lymphosarcoma (1/41). Oral antibiotic treatment was effective in 77% (23/30 dogs), but prolonged treatment (> 4 weeks) was required to control signs and prevent recurrence in 50% (15/30). Corticosteroids were used alone in a dog with eosinophilic enteritis and in combination with antibiotics in 4 dogs with marked gastrointestinal lymphocytic/plasmacytic infiltrates. This study suggested that SIBO may be observed in dogs of many breeds, without an obvious primary cause, and that, although results of indirect tests may be suggestive of SIBO, bacterial culture of duodenal juice samples remains necessary for definitive diagnosis.

Topics: Animals; Anti-Bacterial Agents; Bacteria; Biopsy; Chronic Disease; Diarrhea; Diet; Dog Diseases; Dogs; Duodenoscopy; Duodenum; Female; Folic Acid; Follow-Up Studies; Gastrointestinal Diseases; Male; Treatment Outcome; Vitamin B 12

Deficiency of vitamin B12 is commonly reported in HIV-infected patients. We measured vitamin B12 levels in 36 HIV-infected patients with chronic diarrhea (> 3 stools/day for six weeks or more). Eight patients had an identifiable cause of diarrhea. Vitamin B12 levels were low in 39%. Sixteen of these patients were selected to undergo further testing, eight patients with low levels of vitamin B12 and eight with normal B12 levels. These 16 patients had both a stage II Schilling test and measurement of multiple serum D-xylose concentrations performed after both oral and intravenous doses of D-xylose. Integrated areas under the curves (AUC) for D-xylose concentration versus time were calculated for intravenous and oral doses, and D-xylose bioavailability was determined. Stage II Schilling tests were abnormal in 11 patients, (69%). D-Xylose bioavailability correlated closely with vitamin B12 absorption (r = 0.648, P < 0.01). Comparisons of mean values for CD4 count, serum albumin, Karnovsky score, six-month weight loss, 1-hr serum D-xylose levels and MCV failed to reveal a significant difference between those with and without abnormal serum vitamin B12 levels. These data indicate that below-normal levels of vitamin B12 are highly prevalent in HIV-infected patients with chronic diarrhea. Malabsorption of vitamin B12 occurs in the setting of an enteropathic process effecting both the proximal and distal small bowel. Since no risk factors for vitamin B12 deficiency could be identified, screening for vitamin B12 deficiency in HIV-infected patients with chronic diarrhea is strongly recommended.

Topics: Chronic Disease; Diarrhea; HIV Infections; HIV-1; Humans; Intestinal Absorption; Linear Models; Malabsorption Syndromes; Male; Prevalence; Schilling Test; Time Factors; Vitamin B 12; Vitamin B 12 Deficiency; Xylose

The haematological status, as well as the fractional absorptions of folic acid (FAFol) and vitamin B12 (FAB12) were studied in 29 children aged 0.7-13.5 years (mean 3.3 years) with chronic diarrhoea due to giardiasis. Small intestinal biopsies revealed mucosal damage in 20 children; the biopsies of the remaining nine children were normal. At the initial investigation the FAFol and FAB12 values were below normal in approximately one-sixth and one-third of patients, respectively. Bacterial overgrowth of the small intestinal tract did not seem to play a role in FAB12 malabsorption. About one-fifth of patients had mild anaemia. None of the patients showed FAB12 insufficiency and only one patient suffered from folate depletion. At follow-up, FAFol, FAB12, haemoglobin and Erc-folate concentrations increased significantly while P-B12 and P-folate remained unchanged. Iron status, as well as dietary intake of iron, appeared insufficient prior to, as well as after treatment. Serum iron, transferrin saturation and haemoglobin concentrations were lower in patients who had acquired the disease abroad or suffered from persistent diarrhoea.

Topics: Child; Child, Preschool; Chronic Disease; Diarrhea; Female; Folic Acid; Follow-Up Studies; Giardiasis; Humans; Infant; Intestinal Absorption; Iron; Iron Deficiencies; Male; Nutritional Requirements; Prospective Studies; Vitamin B 12

A test for simultaneous estimation of vitamin B12 and fat absorption from stool samples was investigated in 25 patients with severe diarrhoea after operation for Crohn's disease. 51CrCl3 was ingested as a non-absorbable marker, 58Co-cyano-cobalamin as vitamin B12 tracer, and 14C-triolein as lipid tracer. Faeces were collected separately for 3 days. Some stool-to-stool variation in the 58Co/51Cr and 14C/51Cr ratios was seen. When the 58Co-B12 and 14C-triolein excretion was estimated in samples of the two stools with the highest activities of 51Cr, the variations of the estimates were less than +/- 10% and +/- 15% of the doses ingested, respectively. Twelve of the 25 patients were not able to collect faeces and urine quantitatively and separately. However, in all patients faeces with sufficient radioactivity for simultaneous estimation of faecal 58Co-B12 and 14C-triolein excretion from stool samples were obtained.

Topics: Adult; Aged; Carbon Radioisotopes; Chromium Radioisotopes; Cobalt Radioisotopes; Crohn Disease; Diagnostic Techniques, Radioisotope; Diarrhea; Feces; Female; Humans; Intestinal Absorption; Lipid Metabolism; Male; Middle Aged; Postoperative Complications; Regression Analysis; Vitamin B 12

In a group of nine children with postenteritis enteropathy (i.e., persisting small-intestinal mucosal damage and failure-to-thrive after an acute episode of gastroenteritis), absorption capacities for vitamin B12 and folic acid were studied and compared with hematological status in peripheral blood. The fractional absorptions of vitamin B12 (FAB12) and folic acid (FAFol) were determined by means of a double-isotope technique employing a single-stool-sample test. The children were examined when growth retardation was maximal, and examinations were repeated during the late recovery period. In spite of considerable small-intestinal mucosal damage, only the absorption of vitamin B12 was markedly affected, while that of folic acid was almost intact. When growth retardation was maximal, FAB12 was below the normal age-correlated range in half of the children. FAB12 was also severely reduced in all longitudinally observed children when compared with the results obtained during the late recovery period (p less than 0.005). FAFol was below the normal range in one fourth of the children, but the reduction was modest and insignificant when compared with the results of repeated examinations during the late recovery period. A moderate iron deficiency was detected in half the children. High levels of plasma vitamin B12, folic acid, and erythrocyte folate were detected at both early and later examinations, indicating that these parameters were not affected by the reduced absorption capacities. However, if malabsorption and chronic diarrhea are combined with low dietary intake of vitamin B12, as is the case for many children in the Third World, depletion of vitamin B12 stores may result.

Topics: Absorption; Diarrhea; Erythrocyte Indices; Failure to Thrive; Female; Folic Acid; Gastroenteritis; Humans; Infant; Infant, Newborn; Longitudinal Studies; Male; Vitamin B 12

Topics: Adult; Calcium; Child, Preschool; Diarrhea; Dumping Syndrome; Female; Humans; Iron; Iron Deficiencies; Male; Postgastrectomy Syndromes; Vitamin B 12; Vitamin B 12 Deficiency

Three patients are presented with a history of chronic watery diarrhea due to bile acid malabsorption, proved by the tauro-23[75Se]selena-25 homocholic acid test and an unequivocal response to cholestyramine therapy. Fecal fat tests, Schilling tests, and barium studies of the small intestine and colon were all normal. Jejunal biopsies were normal but multiple biopsies of the terminal ileum, performed by retrograde ileoscopy, showed uniform crypt hyperplastic villous atrophy and features of colonic metaplasia with increased mononuclear infiltration of the lamina propria. All 3 patients demonstrated evidence of abnormal immune function, including the presence of serum autoantibodies, circulating immune complexes, and hypocomplementemia. One patient had Sjögren's syndrome. This disorder, which might be immunologically mediated, should be called primary bile acid malabsorption and should be distinguished from other ileal disorders.

Topics: Adult; Aged; Antibody Formation; Bile Acids and Salts; Cholestyramine Resin; Diarrhea; Female; Humans; Ileum; Intestinal Mucosa; Intestines; Malabsorption Syndromes; Male; Vitamin B 12

27 patients with pernicious anaemia, followed for a long period, were consecutively treated with 3 different vitamin B12 preparations while, during intervening periods, no therapy was given until signs of B12 deficiency developed. The mean of the vitamin B12-free period lasted 400 d. Some patients were 'short-reactors' whereas others were 'long-reactors'. Some patients repeatedly revealed deficiency signs at cobalamin values greater than 200 pmol/l and others at values less than 50 pmol/l, pointing to individually different cut-off points for appearance of signs of deficiency. Hypersegmentation was the first sign in about 2/3, neuropathy in 1/3 and mucosal changes in about 1/10 of the patients. The same type of deficiency was repeatedly noted in the same patient. The daily decline of plasma cobalamin values decreased during the vitamin B12-free period. In perorally treated patients the unsaturated transcobalamin values showed an inverse relationship to the cobalamin values. Marked increases in unsaturated transcobalamin I values were noted in 4 of 16 patients treated with B12 injections, resulting in prolonged high cobalamin values and prolongation of the vitamin B12-free periods.

Topics: Adult; Aged; Anemia, Pernicious; Diarrhea; Erythrocytes; Female; Humans; Male; Middle Aged; Mucous Membrane; Nervous System Diseases; Pain; Time Factors; Transcobalamins; Vitamin B 12; Vitamin B 12 Deficiency

To make a food preparation containing radioactively labelled cobalamins, rabbits were given repeated injections with 57Co-labelled cyanocobalamin. The liver was removed, homogenized, and fried for 1 min or boiled for 30 min. Of the radioactivity in the fried homogenate 41.7% was recovered in the centrifuged supernatant compared with 50.8% in the boiled homogenate. The radioactivity in the supernatants had a molecular size close to that of free 57Co-labelled cyanocobalamin. Forty-two per cent of the radioactivity in the whole homogenate had been incorporated into 5-deoxyadenosyl-, 10% into methyl-, and 16.5% into hydroxy-cobalamin. To assess the validity of a double-isotope method for measuring the intestinal absorption of doses of the 57Co-labelled liver cobalamins, 51CrCl3 was used as a non-absorbable marker. In 14 healthy volunteers the correlation coefficient between the absorption measured by the double-isotope technique and the faecal excretion test was highly significant (r = 0.96, p less than 0.005), and there was only a small variation in the 57Co/51Cr ratio in successive stool collections. In 11 patients with chronic diarrhoea there was a significant correlation between the absorption measured by the double-isotope technique and the faecal excretion test (r = 0.92, p less than 0.005), but in some patients there was considerable variation in the 57Co/51Cr ratio in successive stool collections.

Topics: Adult; Aged; Animals; Chromatography, Gel; Chronic Disease; Cobalt Radioisotopes; Diagnosis, Differential; Diarrhea; Food; Humans; Intestinal Absorption; Intrinsic Factor; Liver; Middle Aged; Molecular Weight; Rabbits; Transcobalamins; Vitamin B 12

The absorption of vitamin B12 and of a synthetic bile acid analogue 75SeHCAT was measured simultaneously in 26 patients presenting with persistent diarrhoea following pelvic irradiation for treatment of carcinoma of the cervix. Four groups were identified, namely patients with isolated bile acid malabsorption, patients with isolated B12 malabsorption, patients with malabsorption of both and those with malabsorption of neither compound. The therapeutic implications are different for each. Measurement of B12 and bile acid absorption comprises an important new test for the management of patients with this disabling and unpleasant complication of radiotherapy.

Topics: Cholestyramine Resin; Chronic Disease; Diagnosis, Differential; Diarrhea; Humans; Intestinal Absorption; Radiation Injuries; Radioisotopes; Selenium; Taurocholic Acid; Vitamin B 12

Sixty-two patients with cervical carcinoma were treated in 1966 to 1968. Thirty-two patients who were alive in 1982 were reevaluated concerning intestinal function. An initial low folate value associated with the disease did not correlate with prognosis. A late low folate value indicated malabsorption and not recurrence of the carcinoma. Malabsorption was found in 5/23 patients (22%) and 3 of these (13%) had vitamin B12 deficiency. Intestinal damage in tumour free patients occurred in 2/62 (3%) patients. It is suggested that late silent complications such as malabsorption should be looked for in the preventive care of these patients.

Topics: Adult; Aged; Diarrhea; Female; Folic Acid; Follow-Up Studies; Humans; Intestinal Absorption; Malabsorption Syndromes; Middle Aged; Prognosis; Radiotherapy; Uterine Cervical Neoplasms; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Actinomycetales Infections; Amino Acids; Bacterial Infections; Bacteroides Infections; Bifidobacterium; Bile Acids and Salts; Clostridium Infections; Diarrhea; Enterobacteriaceae Infections; Folic Acid; Humans; Indican; Intestinal Absorption; Intestinal Diseases; Intestinal Mucosa; Intestine, Small; Lactobacillaceae; Malabsorption Syndromes; Monosaccharides; Protein-Energy Malnutrition; Veillonella; Vitamin B 12

An attempt was made to elucidate the mechanism of diarrhoea resulting from pelvic and abdominal radiotherapy in a prospective study of 10 patients undergoing treatment for curable pelvic malignant tumours using the synthetic trihydroxy 75Se-labelled conjugated bile acid, SeHcat and 58Co-labelled cyanocobalamin (58Co Vit B12). Evidence of malabsorption of vitamin B12 measured as a significant fall in whole body percentage retention of 58Co Vit B12 from baseline levels was found in all nine patients who developed diarrhoea during radiotherapy. Only four out of these nine patients also had malabsorption of the trihydroxy conjugated bile acid, cholic acid, measured as a significant fall in SeHcat whole body percentage retention and these patients had the most severe diarrhoea. The findings are discussed in the light of what is known about the pathophysiology of diarrhoea during pelvic and abdominal radiotherapy and lend support to previous work which implicated increased bowel motility in the pathogenesis of radiation-induced diarrhoea. The hypothesis that local neuroendocrine mechanisms in the gut may be involved is put forward, with possible implications for treatment.

Topics: Adult; Aged; Cobalt Radioisotopes; Diarrhea; Female; Gastrointestinal Motility; Humans; Intestinal Absorption; Male; Middle Aged; Pelvic Neoplasms; Prospective Studies; Radioisotopes; Radiotherapy; Selenium; Taurocholic Acid; Vitamin B 12

Vitamin B12 deficiency was found in 10 of 41 patients who underwent radiotherapy before cystectomy with Bricker urinary diversion for carcinoma of the bladder. Of 13 patients given full irradiation because of inoperable bladder cancer 5 had malabsorption of vitamin B12. Serum folic acid was normal in these patients, indicating predominantly ileal irradiation sequelae. Routine evaluation of serum vitamin B12 after radiotherapy is recommended so that appropriate medication can be given, if possible before neurological symptoms appear.

Topics: Aged; Diarrhea; Erythrocyte Indices; Female; Folic Acid; Hemoglobins; Humans; Intestinal Absorption; Male; Middle Aged; Radiotherapy; Urinary Bladder; Urinary Bladder Neoplasms; Urinary Diversion; Vitamin B 12; Vitamin B 12 Deficiency

Eleven morbidly obese patients were studied before and at various time intervals after jejunoileal bypass (JIB). Bile acid deconjugation was assessed with the bile acid breath test and bile acid absorption by analyzing the fecal excretion of both radioactively labeled and unlabeled bile acids. In addition, aerobic and anaerobic cultures of upper small intestinal aspirates, the Schilling vitamin B12 absorption test, and fecal fat analysis were performed. All patients developed marked diarrhea and steatorrhea after JIB. The bile acid breath test was positive in all 11 patients after JIB. In 7 of the 11 patients, this test was already slightly positive before JIB. In every instance, however, the bile acid breath test became significantly more abnormal after the bypass operation. The fecal excretion of labeled bile acids increased significantly. However, the increase in the quantitative excretion of the bile acids did not reach statistical significance. The concentrations of bile acids in fecal water were considerably below the levels required to induce diarrhea. This was mainly the result of a low fecal pH and consequent low aqueous solubility. Jejunoileal bypass effected a major shift in fecal bile acids from the secondary bile acids, lithocholic acid and deoxycholic acid, to the respective primary compounds, chenodeoxycholic acid and cholic acid. There were no significant changes in the small bowel bacteriologic findings after JIB. In 5 out of the 9 patients in whom bacteriologic studies were performed, the cultures were positive before the operation. The Schilling vitamin B12 absorption test showed in all patients a significant drop in the 24-hour urinary 57Co excretion rate after JIB.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Bile Acids and Salts; Breath Tests; Diarrhea; Enterohepatic Circulation; Fats; Feces; Female; Humans; Ileum; Intestinal Absorption; Intestine, Small; Jejunum; Malabsorption Syndromes; Male; Middle Aged; Obesity; Postoperative Complications; Vitamin B 12

Topics: Bile Acids and Salts; Celiac Disease; Cholelithiasis; Crohn Disease; Diarrhea; Humans; Ileocecal Valve; Intestinal Absorption; Intestine, Small; Mesenteric Arteries; Mesenteric Vascular Occlusion; Mesenteric Veins; Thrombosis; Vitamin B 12

Topics: Adult; Aftercare; Aged; Anemia, Hypochromic; Diarrhea; Disseminated Intravascular Coagulation; Embolism; Enterocolitis, Pseudomembranous; Female; Gastric Juice; Humans; Intestinal Absorption; Intestine, Small; Iron; Male; Mesenteric Arteries; Mesentery; Middle Aged; Mitral Valve Insufficiency; Sarcoma; Stomach Ulcer; Vitamin B 12

To determine the nature and frequency of malabsorption in patients with continent ileostomies, faeces and urine from 42 patients with ileal pouches and from 19 patients with conventional ileostomies were analysed and compared. The patients with conventional ileostomy were matched with patients with ileal pouches. Thirteen of the patients with pouches were found to have excessive faecal volumes which were accompanied by increased faecal losses of electrolytes, nitrogen, and fat, and by decreased vitamin B12 uptake. The remaining patients with continent ileostomies had faecal and urinary outputs which were similar to those of patients with conventional ileostomies. Thus, evidence of malabsorption was found in approximately 30% of this group of patients with continent ileostomies.

Topics: Adult; Aged; Diarrhea; Dietary Fats; Electrolytes; Feces; Female; Humans; Ileostomy; Intestinal Absorption; Male; Middle Aged; Nitrogen; Vitamin B 12

Although gastric resection may cause a variety of functional gastrointestinal disorders, malabsorption is rare. When such a disturbance occurs other complicating factors are mostly involved. Two patients who developed a severe malabsorption after partial gastric resection are presented. They both had the prerequisites for intestinal stasis--one had small bowel diverticula and the other a "blind loop" after previous surgery. Their malabsorption was cured by surgical correction of stasis.

Topics: Adult; Blind Loop Syndrome; Diarrhea; Dietary Fats; Dietary Proteins; Humans; Malabsorption Syndromes; Male; Middle Aged; Vitamin B 12

Topics: Achlorhydria; Adenoma, Islet Cell; Blood Glucose; Calcium; Dehydration; Diarrhea; Gastric Juice; Gastrointestinal Hormones; Humans; Hypokalemia; Pancreatic Juice; Pancreatic Neoplasms; Syndrome; Vitamin B 12

Topics: Alcoholism; Diarrhea; Folic Acid Deficiency; Humans; Intestinal Absorption; Intestinal Diseases; Intestine, Small; Malabsorption Syndromes; Vitamin B 12; Xylose

Topics: Anemia, Hypochromic; Celiac Disease; Crohn Disease; Diarrhea; Folic Acid; Humans; Ileum; Intestinal Absorption; Iron; Physician-Patient Relations; Vitamin B 12; Vitamin B 12 Deficiency

Idiopathic late-onset immunoglobulin deficiency in a young man was associated with achlorhydria and a severe intestinal malabsorption syndrome that did not respond to conventional therapy. Combined therapy with high doses of prednisone and tetracycline hydrochloride resulted in weight gain, cessation of diarrhea, improved absorption of water, fat, and vitamin B12, and production of gastric acid after stimulation with histamine. Serum immunoglobulin levels, however, did not increase.

Topics: Achlorhydria; Adult; Age Factors; Body Weight; Celiac Disease; Cholecystokinin; Diarrhea; Drug Therapy, Combination; Humans; Immunoglobulin M; Immunologic Deficiency Syndromes; Malabsorption Syndromes; Male; Prednisone; Tetracycline; Vitamin B 12

Topics: Adult; Anemia, Macrocytic; Biological Transport; Carrier Proteins; Diarrhea; Electrophoresis, Polyacrylamide Gel; Female; Humans; Immunodiffusion; Immunoelectrophoresis; Immunologic Deficiency Syndromes; Infant, Newborn; Injections, Intramuscular; Malabsorption Syndromes; Metabolism, Inborn Errors; Pregnancy; Protein Binding; Radioisotopes; Vitamin B 12

The first partial ileal bypass operation specifically for the reduction of plasma lipids was performed by us in 1963. Since then we have operated upon and followed for more than three months 126 hyperlipidemic patients. Clinical metabolic studies, before and after the procedure, have demonstrated a 60% decrease in cholesterol absorption, a 3.8-fold increase in total fecal steroid excretion, a 5.7-fold increase in cholesterol synthesis, a 3-fold increase in cholesterol turnover, and a one-third decrease in the miscible cholesterol pool. Circulating cholesterol levels have been lowered an average 41.1% from the preoperative but postdietary baseline. An average 53% cholesterol reduction has been achieved from a pretreatment baseline using a combination of dietary and surgical management. Plasma triglycerides have been reduced in primary hypertriglyceridemic patients (type IV) an average of 52.6% from their preoperative but postdietary baseline. One patient died in the hospital and there have been 13 late deaths over the past 10 years. Four cases of postoperative bowel obstruction required reoperation. Diarrhea following partial ileal bypass is, as a rule, transistory and not a significant problem. No appreciable weight loss results from partial ileal bypass, which is an obvious distinction from the results of the far more massive jejuno-ileal bypass procedure for obesity. We have not encountered hepatotoxic, lithogenic, or nephrolithiasis complications in our partial ileal bypass patients. Sixty-nine per cent of our patients with preoperative angina pectoris have postoperative improvement or total remission of this symptom complex. Serial appraisal of followup coronary arteriographic studies offers preliminary evidence for lesion regression. It is concluded that partial ileal bypass is the most effective means for lipid reduction available today; it is obligatory in its actions, safe, and associated with minimal side effects.

Topics: Adolescent; Adult; Angina Pectoris; Angiocardiography; Child; Cholesterol; Diarrhea; Feces; Female; Follow-Up Studies; Humans; Hyperlipidemias; Ileum; Male; Middle Aged; Postoperative Complications; Steroids; Triglycerides; Vitamin B 12

Topics: Adolescent; Adult; Aged; Amylases; Bile Acids and Salts; Body Weight; Celiac Disease; Colectomy; Crohn Disease; Diarrhea; Disability Evaluation; Duodenum; Female; Follow-Up Studies; Humans; Ileostomy; Intestinal Absorption; Intestinal Secretions; Malabsorption Syndromes; Male; Middle Aged; Pancreas; Postoperative Complications; Vitamin B 12

Topics: Abetalipoproteinemia; Acrodermatitis; Amino Acid Metabolism, Inborn Errors; Amino Acids; Amylases; Amyloidosis; Carbohydrate Metabolism, Inborn Errors; Copper; Cystic Fibrosis; Cystinuria; Diarrhea; Fanconi Syndrome; Fats; Folic Acid; Fructose Intolerance; Glucosidases; Hartnup Disease; Humans; Intestinal Absorption; Lactose Intolerance; Magnesium; Malabsorption Syndromes; Monosaccharides; Pancreatitis; Phenylketonurias; Rickets; Vitamin B 12

Topics: Achlorhydria; Anemia, Megaloblastic; Anorexia Nervosa; Body Weight; Bone Marrow Cells; Celiac Disease; Diarrhea; Gastritis; Hemoglobinometry; Humans; Jejunum; Malabsorption Syndromes; Sprue, Tropical; Tetracycline; Vitamin B 12; Zimbabwe

Topics: Anemia, Macrocytic; Animals; Asthenia; Body Weight; Diarrhea; Feeding and Eating Disorders; FIGLU Test; Folic Acid; Folic Acid Deficiency; Gingivitis; Humans; Leukopenia; Liver; Male; Malonates; Papio; Thrombocytopenia; Vitamin B 12

Topics: Adolescent; Adult; Bacteroides; Bile Acids and Salts; Breath Tests; Carbon Dioxide; Carbon Radioisotopes; Diarrhea; Escherichia coli; Female; Glycine; Glycocholic Acid; Humans; Ileum; Intestinal Absorption; Jejunum; Male; Middle Aged; Obesity; Schilling Test; Taurine; Vitamin B 12

Topics: Adult; Aged; Alkaline Phosphatase; Anemia, Hypochromic; Binding Sites; Calcium; Diarrhea; Dumping Syndrome; Female; Folic Acid; Follow-Up Studies; Gastrectomy; Hemoglobins; Humans; Iron; Male; Methods; Middle Aged; Phosphorus; Postoperative Complications; Serum Albumin; Serum Globulins; Stomach Ulcer; Vitamin B 12; Vomiting

Topics: Adolescent; Adult; Age Factors; Bile Acids and Salts; Child; Colon; Colostomy; Crohn Disease; Diarrhea; Feces; Female; Humans; Ileostomy; Ileum; Intestinal Absorption; Lipid Metabolism; Male; Methods; Middle Aged; Recurrence; Vitamin B 12

Topics: Adult; Aerobiosis; Bacteria; Diarrhea; Humans; India; Intestinal Mucosa; Jejunum; Malabsorption Syndromes; Sprue, Tropical; Travel; Vitamin B 12; Xylose

Thirty-four cases of malabsorption are described in young adults after brief periods of overland travel to India. Symptoms included diarrhoea, abdominal distension, and weight loss. Investigation revealed fat, xylose, and vitamin B(12) malabsorption with marked morphological changes in the mucosa. Lower levels of serum folate and vitamin B(12) were observed in those with protracted diarrhoea, but no anaemia developed. Malabsorption may persist for many months after return to the U.K. Most patients responded initially to antibiotics, but some subsequently relapsed. The reasons why these patients developed tropical sprue are discussed.

Topics: Adult; Asia, Western; Biopsy; Body Weight; Celiac Disease; Diarrhea; Fats; Female; Folic Acid; Humans; India; Intestinal Absorption; Jejunum; Malabsorption Syndromes; Male; Tetracycline; Travel; Vitamin B 12; Xylose

Topics: Animals; Bacteria; Blood Proteins; Body Weight; Colectomy; Colon; Diarrhea; Dogs; Ileum; Intestine, Small; Methods; Time Factors; Vitamin B 12

Topics: Body Height; Child; Child Nutritional Physiological Phenomena; Child, Preschool; Cobalt Isotopes; Convalescence; Creatinine; Diarrhea; Diarrhea, Infantile; Diet Therapy; Dietary Proteins; Humans; Ileum; Infant; Infant Nutrition Disorders; Infant Nutritional Physiological Phenomena; Intrinsic Factor; Malabsorption Syndromes; Nutrition Disorders; Protein-Energy Malnutrition; Schilling Test; Vitamin B 12

Topics: Adult; Anemia; Biopsy; Blind Loop Syndrome; Chronic Disease; Diarrhea; Gastrointestinal Hemorrhage; Humans; Intestinal Absorption; Intestinal Mucosa; Malabsorption Syndromes; Male; Radiography; Ulcer; Vitamin B 12

Thirteen cases are described of temporary malabsorption in adults presenting after an episode of apparent infective enteritis. Clinical features included diarrohea, anorexia, and weight loss. Investigations indicated diffuse impairment of function in the small bowel, including the ileum, with well-preserved mucosal morphology in the upper jejunum and a tendency to rapid folate depletion. Spontaneous recovery usually occurred within weeks but two cases ran a more prolonged and severe course.The clinical features of this syndrome are those of tropical sprue, but the outcome of the illness is probably influenced by nutritional as well as environmental factors. There may be a gradation of severity of illness from megaloblastic anaemia to florid malabsorption syndrome.

Topics: Adult; Agglutination Tests; Anemia, Macrocytic; Body Weight; Diarrhea; Enteritis; Feeding and Eating Disorders; Folic Acid Deficiency; Humans; Ileum; Intestine, Small; Jejunum; Malabsorption Syndromes; Middle Aged; Sprue, Tropical; Vitamin B 12

Topics: Adaptation, Physiological; Animals; Blood Proteins; Diarrhea; Dogs; Feces; Female; Gastrointestinal Motility; Hemoglobinometry; Intestinal Absorption; Intestinal Mucosa; Intestine, Small; Intestines; Lipids; Malabsorption Syndromes; Male; Vitamin B 12; Xylose

Topics: Adolescent; Adult; Diarrhea; Diet; Female; Humans; Ileum; Jejunum; Male; Methods; Middle Aged; Obesity; Postoperative Care; Postoperative Complications; Preoperative Care; Vitamin B 12

Topics: Aged; Cholelithiasis; Crohn Disease; Diarrhea; Female; Gastrointestinal Agents; Humans; Ileum; Ischemia; Kidney Calculi; Lignin; Malabsorption Syndromes; Male; Mesentery; Middle Aged; Postoperative Complications; Preoperative Care; Vitamin A; Vitamin B 12; Vitamin D; Vitamin K

Topics: Adolescent; Adult; Bile Acids and Salts; Diarrhea; Enzymes; Female; Folic Acid; Humans; Hypothalamic Diseases; Ileum; Intestinal Absorption; Intestine, Small; Jejunum; Kidney Function Tests; Lipids; Liver Function Tests; Male; Methods; Middle Aged; Obesity; Postoperative Complications; Vitamin B 12; Water-Electrolyte Balance

Topics: Adenoma, Islet Cell; Bicarbonates; Celiac Disease; Diarrhea; Duodenum; Feces; Female; Gastric Juice; Humans; Hyperplasia; Hypokalemia; Intestinal Secretions; Malabsorption Syndromes; Middle Aged; Pancreas; Pancreatic Neoplasms; Pancreatitis; Potassium; Precancerous Conditions; Vitamin B 12

A 68-year-old man presenting with chronic intermittent diarrhea and progressive ataxia was found to have idiopathic hypoparathyroidism. Intrinsic factor-resistant vitamin B(12) malabsorption was demonstrated. Both the diarrhea and vitamin malabsorption were reversed by correction of hypocalcemia.His neurological profile was a combination of peripheral nerve, posterior column and cerebellar deficits. He had calcifications in the dentate nuclei of the cerebellum. Possible etiological factors such as vitamin B(12) deficiency, folic acid deficiency and steatorrhea have been excluded. Posterior column and cerebellar abnormalities improved with treatment. It is postulated that hypocalcemia causes functional, reversible spinal cord and cerebellar dysfunction.

Topics: Aged; Calcinosis; Calcium; Cerebellar Diseases; Diarrhea; Humans; Hypocalcemia; Hypoparathyroidism; Male; Peripheral Nervous System Diseases; Phosphorus; Spinal Cord Diseases; Vitamin B 12; Vitamin D

Topics: Adolescent; Adult; Aged; Anemia, Hypochromic; Child; Child, Preschool; Chronic Disease; Diarrhea; Duodenal Ulcer; Female; Humans; Iron; Italy; Liver Extracts; Male; Menorrhagia; Menstruation; Metrorrhagia; Middle Aged; Pregnancy; Pregnancy Complications, Hematologic; Stomach Ulcer; Vitamin B 12

Topics: Bile Acids and Salts; Biotransformation; Celiac Disease; Cholelithiasis; Cholestyramine Resin; Diarrhea; Humans; Hypercholesterolemia; Ileum; Intestinal Diseases; Kidney Calculi; Lipid Metabolism; Malabsorption Syndromes; Obesity; Postoperative Complications; Vitamin B 12; Water-Electrolyte Balance

Topics: Anemia, Hypochromic; Bile Acids and Salts; Body Weight; Celiac Disease; Crohn Disease; Diarrhea; Diet Therapy; Dietary Fats; Dietary Proteins; Humans; Hypoproteinemia; Ileum; Intestinal Absorption; Jejunum; Lipid Metabolism; Nutrition Disorders; Serum Albumin; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Celiac Disease; Diarrhea; Dumping Syndrome; Enzyme Therapy; Folic Acid; Gastrectomy; Gastroesophageal Reflux; Humans; Iron; Male; Middle Aged; Postoperative Care; Postoperative Complications; Tranquilizing Agents; Vitamin B 12

Topics: Adult; Aged; Cholera; Diarrhea; Enteritis; Feces; Female; Folic Acid; Glucose Tolerance Test; Humans; Intestinal Absorption; Intestine, Small; Jejunum; Male; Methods; Middle Aged; Salmonella Infections; Time Factors; Vitamin B 12; Xylose

Topics: Acids; Adult; Aged; Bile Acids and Salts; Diarrhea; Diet; Digestive System; Enterobacteriaceae; Feces; Female; Humans; Indican; Male; Middle Aged; Vagotomy; Vitamin B 12

Topics: Bile Acids and Salts; Celiac Disease; Cholelithiasis; Diagnosis, Differential; Diarrhea; Humans; Ileum; Intestinal Absorption; Intestinal Diseases; Lipid Metabolism; Vitamin B 12

Topics: Adolescent; Adult; Anemia, Macrocytic; Atrophy; Biopsy; Bone Marrow Cells; Child; Cobalt Isotopes; Diarrhea; Edema; Female; Folic Acid; Folic Acid Deficiency; Humans; Intestinal Absorption; Intestinal Mucosa; Jejunum; Liver Diseases; Malabsorption Syndromes; Male; Middle Aged; Protein Deficiency; Serum Albumin; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Absorption; Adult; Cholera; Chromium Isotopes; Cobalt Isotopes; Diarrhea; Diffusion; Edetic Acid; Glomerular Filtration Rate; Humans; Ileum; India; Indicator Dilution Techniques; Indicators and Reagents; Intestinal Absorption; Intestine, Small; Intrinsic Factor; Intubation, Gastrointestinal; Jejunum; Male; Sulfobromophthalein; Vitamin B 12; Xylose

Topics: Agammaglobulinemia; Anemia, Pernicious; Antibodies; Arthritis; Blood Protein Electrophoresis; Bronchiectasis; Diarrhea; Humans; Male; Middle Aged; Prednisone; Radiography; Schilling Test; Vitamin B 12

Topics: Biguanides; Cobalt Isotopes; Diabetes Mellitus; Diarrhea; Humans; Intestinal Absorption; Intrinsic Factor; Obesity; Schilling Test; Vitamin B 12

Topics: Body Weight; Carbohydrate Metabolism; Colon; Diarrhea; Digestive System Surgical Procedures; Electrolytes; Female; Humans; Hypertension; Ileum; Jejunum; Lipid Metabolism; Liver Diseases; Malabsorption Syndromes; Male; Methods; Obesity; Postoperative Complications; Preoperative Care; Proteins; Prothrombin; Stomach; Vitamin B 12

Topics: Adult; Ascorbic Acid Deficiency; Celiac Disease; Diarrhea; Employment; Fatty Liver; Female; Humans; Intestinal Absorption; Intestine, Small; Magnesium Deficiency; Male; Middle Aged; Obesity; Vitamin A Deficiency; Vitamin B 12

Topics: Adult; Azathioprine; Blood Proteins; Body Weight; Crohn Disease; Diarrhea; Diet Therapy; Feces; Female; Humans; Intestinal Absorption; Lipid Metabolism; Liver Function Tests; Male; Time Factors; Vitamin B 12

Topics: Adult; Anemia, Macrocytic; Calcium; Carotenoids; Celiac Disease; Diarrhea; Edema; Emaciation; Feces; Female; Glutens; Hematocrit; Humans; Immunoglobulins; Intestinal Mucosa; Male; Middle Aged; Pancreatin; Phosphorus; Potassium; Pregnancy; Pregnancy Complications, Hematologic; Prothrombin Time; Serum Albumin; Tetany; Thrombophlebitis; Vitamin B 12; Xylose

Topics: Adolescent; Bile Acids and Salts; Diarrhea; Female; Homeostasis; Humans; Ileum; Intestine, Small; Male; Middle Aged; Postoperative Complications; Vitamin B 12

Topics: Adult; Angina Pectoris; Cholesterol; Diarrhea; Feces; Female; Humans; Hypercholesterolemia; Intestine, Small; Lipids; Male; Middle Aged; Nitrogen; Postoperative Complications; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Achlorhydria; Adult; Agammaglobulinemia; Anemia, Pernicious; Antibodies; Arthritis, Rheumatoid; Atrophy; Autoimmune Diseases; Colitis, Ulcerative; Diarrhea; Female; Fluorescent Antibody Technique; gamma-Globulins; Gastric Mucosa; Gastritis; Giardiasis; Humans; Hypersensitivity; Hypersensitivity, Delayed; Infections; Intrinsic Factor; Male; Middle Aged; Vitamin B 12

Topics: Adult; Blood Protein Electrophoresis; Carbon Isotopes; Coronary Disease; Diarrhea; Female; Humans; Hypercholesterolemia; Ileum; Lipids; Male; Middle Aged; Time Factors; Vitamin A; Vitamin B 12; Xylose

Topics: Age Factors; Biopsy; Child; Diarrhea; Feces; Female; Follow-Up Studies; Gastric Juice; Humans; India; Intestinal Absorption; Jejunum; Lipids; Male; Radiography; Serum Albumin; Sex Factors; Sprue, Tropical; Stomach; Vitamin B 12

Topics: Achlorhydria; Adult; Anemia, Pernicious; Diarrhea; Female; Hematocrit; Humans; Male; Middle Aged; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adolescent; Diarrhea; Humans; Male; Sprue, Tropical; Thailand; Vitamin B 12; Xylose

Topics: Animals; Arsenic; Arsenic Poisoning; Cattle; Cattle Diseases; Diarrhea; Feces; Female; Food Contamination; Male; Thiosulfates; Vitamin B 12

Topics: Amylases; Body Weight; Diarrhea; Digestive System; Gastrectomy; Glucose Tolerance Test; Hemoglobins; Humans; Intestinal Absorption; Iron; Lipase; Malabsorption Syndromes; Pancreas; Vitamin B 12

Topics: Adrenal Gland Neoplasms; Catecholamines; Child, Preschool; Chlorides; Colon; Diarrhea; Digestive System; Ganglioneuroma; Gastrointestinal Motility; Humans; Kidney; Magnesium; Male; Muscle Contraction; Potassium; Radiography; Sodium; Vitamin B 12

Topics: Adolescent; Adult; Aged; Biopsy; Bone Marrow Examination; Dapsone; Dermatitis Herpetiformis; Diarrhea; Diet Therapy; Female; Folic Acid; Glutens; Humans; Intestinal Mucosa; Jejunum; Malabsorption Syndromes; Male; Middle Aged; Vitamin B 12

Topics: Anemia, Hypochromic; Avitaminosis; Body Weight; Carbohydrate Metabolism; Diarrhea; Disaccharides; Edema; Feces; Folic Acid; Glucose; Humans; Hypocalcemia; Hypokalemia; Hypoproteinemia; Intestinal Absorption; Intestine, Small; Iron; Malabsorption Syndromes; Vitamin A; Vitamin B 12; Vitamin K; Xylose

Topics: Adult; Aged; Cobalt Isotopes; Constipation; Diabetes Complications; Diarrhea; Female; Humans; Iodine Radioisotopes; Male; Middle Aged; Vitamin B 12

Topics: Adult; Body Weight; Child; Cholesterol; Cobalt Isotopes; Deficiency Diseases; Diarrhea; Folic Acid; Haiti; Hemoglobinometry; Humans; Intestinal Mucosa; Iron; Jejunum; Malabsorption Syndromes; Nutritional Physiological Phenomena; Protein Deficiency; Rural Health; Serum Albumin; Sprue, Tropical; Vitamin B 12; Xylose

Topics: Biopsy; Chronic Disease; Cobalt Isotopes; Diarrhea; Dietary Proteins; Fats; Feces; Folic Acid; Humans; Ileum; India; Intestinal Mucosa; Jejunum; Malabsorption Syndromes; Sprue, Tropical; Tetracycline; Tropical Climate; Vitamin B 12; Xylose

Topics: Animals; Diarrhea; Digestive System; Folic Acid; Guinea Pigs; Injections, Intraperitoneal; Pantothenic Acid; Pyridoxine; Radiation Injuries, Experimental; Radiometry; Rats; Vitamin B 12

Topics: Adult; Anemia, Pernicious; Antibodies; Blood Protein Disorders; Blood Proteins; Cobalt Isotopes; Diarrhea; gamma-Globulins; Humans; Intrinsic Factor; Male; Vitamin B 12

Topics: Achlorhydria; Clostridium perfringens; Diarrhea; Digestive System; Enterobacteriaceae; Enterococcus faecalis; Feces; Gastrectomy; Gastric Acidity Determination; Gastroenterostomy; Humans; Intestine, Small; Jejunum; Lipids; Stomach; Vagotomy; Vitamin B 12

Topics: Anti-Bacterial Agents; Carbohydrate Metabolism; Cholera; Diarrhea; Drug Therapy; Folic Acid; Foodborne Diseases; Gastroenteritis; Humans; Intestine, Small; Intestines; Malabsorption Syndromes; Pakistan; Salmonella Infections; Shigella; Staphylococcal Infections; Statistics as Topic; Vitamin B 12; Xylose

Topics: Animals; Cobalt Isotopes; Diarrhea; Intestinal Absorption; Intestine, Small; Rats; Vitamin B 12

Topics: Blood Pressure; Cholesterol; Diarrhea; Female; Glucose Tolerance Test; Humans; Jejunum; Lipid Metabolism; Lipids; Middle Aged; Nitrogen; Obesity; Phospholipids; Urine; Vitamin B 12

Topics: Congenital Abnormalities; Diarrhea; Dietary Fats; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Absorption; Intestinal Obstruction; Intestine, Small; Intestines; Iron; Prothrombin; Surgical Procedures, Operative; Vitamin B 12; Vitamin K

Topics: Cobalt Isotopes; Corrinoids; Diarrhea; Digestion; Humans; Intrinsic Factor; Pellagra; Vitamin B 12

Topics: Anti-Bacterial Agents; Celiac Disease; Diabetes Complications; Diabetes Mellitus; Diagnosis, Differential; Diarrhea; Intestinal Diseases; Liver Extracts; Pancreatic Extracts; Pathology; Radiography; Thiamine; Vitamin B 12

Topics: Celiac Disease; Diarrhea; Diverticulum; Duodenal Diseases; Escherichia coli Infections; Humans; Intestinal Diseases; Intestines; Sprue, Tropical; Steatorrhea; Tetracycline; Vitamin B 12

Topics: Animals; Chlortetracycline; Chromosome Disorders; Diarrhea; Edible Grain; Radiation Chimera; Radiation Injuries, Experimental; Vitamin B 12

Topics: Corrinoids; Diarrhea; Folic Acid; Humans; Riboflavin; Syndrome; Vitamin A; Vitamin B 12; Vitamin B Complex; Vitamins

Topics: Animals; Chlortetracycline; Diarrhea; Methionine; Swine; Vitamin B 12