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PubMed1983

[Changes in the gastric mucosa in complicated forms of peptic ulcer and postgastrectomy syndromes].

Complex studies of the secretory function of the stomach have shown its activity to depend upon the type of gastric ulceration. It allows gastric ulcers to be differentiated into those with hyposecretory (primary ulcers) and hypersecretory (associated and secondary ulcers) syndromes. High secretory activity of the stomach with duodenal ulcers is confirmed by the results of morphological investigations.

Dumping Syndrome↗
PubMed1991

[Diagnosis of protein-losing gastroenteropathy by 111In-transferrin scanning and fecal excretion test].

A total of twelve patients with gastroenteropathy were studied for possible protein loss. The underlying diseases were intestinal lymphangiectasia, ulcerative colitis and Crohn's disease in 2 patients each; and Ménétrier's disease, Cronkhite-Canada syndrome, postgastrectomy syndrome, severe atrophic gastritis, gastric cancer and gastroenteropathy of unknown origin in 1 patient each. The controls used in this study were four healthy volunteer and 9 patients with benign disease not accompanied by lesions in the digestive tract and protein loss, 111In-transferrin (Tf) was prepared by incubating 2-3 mCi of 111In-chloride with 15-20 ml of each patient's plasma in a sterilized vial at room temperature for 1 hour. After i.v. injection of 111In-Tf, the patients were scanned at given intervals of time for 72 hours to localize protein loss. 72-hour fecal 111In-Tf excretion was also measured. The following results were obtained: (1) 111In-Tf was detected in the feces of all patients. The recovery rate in the patient group was 7.95 +/- 3.65%, which was significantly higher than 0.48 +/- 0.26% in the control group (p less than 0.01). (2) However, 111In-Tf scanning showed the site of protein loss only in 6 patients. Negative scan in six other patients was thought to be associated with extensive inflammation and severe diarrhea. (3) Five of the twelve patients were observed before and after treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Causes of malabsorption in the elderly.

The pathogenesis of malabsorption has been studied in 70 patients who presented over the age of 65 years and who were referred to a special investigative unit. Often more than one cause was apparent. Fourteen patients had pancreatic insufficiency, most of whom had no history of pain, alcoholism or gallstones. Twenty-three patients had the postgastrectomy syndrome or small-bowel diverticulosis or both. There were eight coeliacs aged 65-72 years at diagnosis. Fifteen patients had an anatomically normal small bowel; eight of these were over 80 years old, and 10 had vitamin B12 deficiency of whom five had confirmed pernicious anaemia. Enterobacterial overgrowth was a feature of all diagnostic groups except pancreatic and coeliac disease. Vitamin B12 deficiency may be an effect of malabsorption, but can also be a cause through impairment of enterocyte function. The association of pernicious anaemia and B12 deficiency with otherwise unexplained malabsorption and bacterial overgrowth suggests that gastric atrophy is a major causal factor in this syndrome, combined in some cases with a 'vicious circle' of B12 malabsorption and deficiency.

Aged↗
PubMed1990

Efficacy of octreotide acetate in treatment of severe postgastrectomy dumping syndrome.

The present study evaluates the acute and chronic use of a long-acting somatostatin analog, octreotide acetate, in the treatment of patients with severe postgastrectomy dumping syndrome. In the acute phase, 10 patients with severe dumping were studied over 2 consecutive days before and for 3 hours after the ingestion of a 'dumping breakfast' in a randomized double-blind fashion. On one day octreotide (100 micrograms) was given subcutaneously 30 minutes before the test meal and on the other day an equal volume of vehicle was injected. An additional group of six postgastrectomy patients without dumping were studied in a similar fashion and these acted as controls. During placebo treatment the test meal resulted in an immediate increase (p less than 0.01) in the pulse rate and in plasma levels of glucose, glucagon, pancreatic polypeptide, neurotensin, and insulin. Similar changes were seen in the control group with respect to placebo; however glucagon and neurotensin (p less than 0.05) did not show the same magnitude of increase as seen with placebo. Treatment with octreotide acetate prevented the development of both vasomotor and gastrointestinal symptoms and completely ablated all of the above responses in plasma peptides. These changes were associated with complete ablation of diarrhea (p less than 0.001). Pretreatment with octreotide acetate completely suppressed the rise in plasma insulin response to the meal and this ablated the late hypoglycemia of dumping. Treatment with octreotide acetate resulted in delayed gastric emptying and transit time (578 +/- 244 minutes) versus 76 +/- 23 minutes with placebo and 125 +/- 36 minutes in controls (p less than 0.05). Chronic daily treatment with octreotide acetate resulted in minimal side effects. These patients demonstrated a stable fasting plasma glucose, normal liver function tests, and an average weight gain of 11% during a 12-month period. In addition most patients were able to resume employment. The long-acting somatostatin analog, octreotide acetate, is highly effective in preventing the development of symptoms of severe dumping syndrome, both vasomotor and gastrointestinal.

Adult↗