Absorptive function of the small intestine in liver cirrhosis

Baraona, Enrique; Orrego, Marly; Fernández, Ó; Amenabar, E; Maldonado, E Juan Guillermo; Tag, Fernando; Salinas, A

doi:10.1007/bf02231855

Cited by 69 publications

(14 citation statements)

References 35 publications

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“…About 207%o of such patients have considerable steatorrhea. The etiology of this malabsorption is not clear, and no correlation between pancreatic insufficiency and fat malabsorption has been shown (10,11).…”

Section: Discussionmentioning

confidence: 99%

“…Intestinal absorption, transport, and hepatic clearance of MCFA in patients with cirrhosis are of interest for two reasons: 1) Fat malabsorption sufficient to contribute to malnutrition is common in cirrhosis ( 10,11 ), and information about the absorption of medium chain fats is lacking. 2) Portacaval shunting of blood and a variable diminution in the capacity of the cirrhotic liver to metabolize MCFA emphasized the need for study of peripheral blood levels after their administration.…”

mentioning

confidence: 99%

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Medium and long chain fat absorption in patients with cirrhosis.

Linscheer¹,

Patterson²,

Moore³

et al. 1966

J. Clin. Invest.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Medium and long chain fat absorption in patients with cirrhosis.

Linscheer¹,

Patterson²,

Moore³

et al. 1966

J. Clin. Invest.

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“…In cirrhotic patients lymph flow and lymph pressure iu the thoracic duct are usually increased as a result of postsinusoidal obstruction to the hepatic blood flow [1], Under the circumstances the lymph drainage of the intestine could be indirectly altered [6]. D ilatation of lym phatics in the villi of the small intestine in liver cirrhosis has been reported by liiiraonu «/ al.…”

Section: Resultsmentioning

confidence: 99%

Gastroenteric Clearance of Albumin in Liver Cirrhosis; Relative Protein-losing Gastroenteropathy

Takada¹,

Kobayashi²,

Takeuchi³

1970

Digestion

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Gastroenteric clearance of albumin was measured to explore the role of an extrahepatic factor related to the development of hypoalbuminemia in liver cirrhosis. Loss of albumin into the gastrointestinal tract was not significantly increased in liver cirrhosis when compaired with the controls. However, loss of serum into the stool and the fractions of the total albumin catabolism represented by the losses into the stool were significantly increased in liver cirrhosis. Significant correlations between portal pressure and albumin excretion into the stool and between serum albumin levels and serum loss into the stool or gastroenteric degradation ratio were observed. These results suggested that, in considering the total catabolic rate, albumin loss into the stool was relatively increased in liver cirrhosis as a consequence of the impairment of the control mechanism of albumin degradation in the gastrointestinal tract.

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“…CD may, therefore, be underdiagnosed in cirrhosis. Studies of SB biopsy in cirrhosis [1][2][3][4][5] , have thus shed doubt on the validity of biopsy in the diagnosis of CD in cirrhotic patients; but reported findings are poorly characterized, lack standardized grading, and of unclear significance. The current study was undertaken to determine if SB biopsies in cirrhosis show features that might mimic CD.…”

Section: Introductionmentioning

confidence: 99%

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mentioning

confidence: 99%

Histological abnormalities of the small bowel mucosa in cirrhosis and portal hypertension

Wakim-Fleming¹,

Zein²,

Bennett³

et al. 2008

WJG

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INTRODUCTIONStudies of small bowel (SB) mucosa in cirrhosis and portal hypertension report a diverse spectrum of histological abnormalities [1][2][3][4][5] . These include increased capillary angiogenesis, mucosal edema, decreased villus to crypt ratio, villus atrophy and decreased total absorptive surface. Villus abnormalities resemble the abnormalities of coeliac disease (CD) and this may affect the interpretation of small bowel biopsy, and lead to confusion when CD is to be excluded in patients with cirrhosis and portal hypertension.The diagnosis of CD is increasingly considered and work up recommended during the evaluation of abnormal liver enzymes [6][7] . This is in part due to the heightened awareness of the association of CD with a variety of liver disorders. Most commonly described associated liver disorders include autoimmune hepatitis, primary biliary cirrhosis, non-alcoholic fatty liver disease, unexplained abnormal liver tests and cirrhosis [8][9][10][11][12][13][14][15] . The mechanisms of this association are not clear and the prevalence of CD in patients with liver disease is variable depending on the associated liver disease. For example, while CD affects 1% of the general population, one study reports that about 4% of 185 cirrhotic patients who had undergone liver transplantation were found to have CD, and 3 of 4 pa- Abstract AIM: To study the small bowel (SB) mucosa on biopsy in cirrhotic patients with portal hypertension and in non-cirrhotic controls and grade findings according to the Marsh criteria. METHODS: We prospectively enrolled 51 consecutive patients undergoing an upper endoscopy for their routine medical care. Twenty five patients with cirrhosis and portal hypertension were compared to 26 controls. We obtained coeliac serology and multiple upper small bowel biopsies on all 51 patients. A GI pathologist interpreted biopsies and graded findings according to the Marsh criteria. We assessed equivalence in Marsh grade between cirrhotic and non-cirrhotic controls using the Mann-Whitney test for equivalence. RESULTS: Gender, ethnicity and age were similar between both groups. Marsh grades were equivalent between the groups. Grade of 0 was present in 96% and grade of 1 was present in 4% of both groups and there was no villus atrophy or decrease in villus/crypt ratio in patients with portal hypertension. CONCLUSION: This study provides evidence for the lack of villus atrophy in patients with cirrhosis and portal hypertension, and supports the continuous reliance on the Marsh criteria when the diagnosis www.wjgnet.comWakim-Fleming J et al . Cirrhosis with portal hypertension does not cause atrophy of the small bowel mucosa 6371

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Absorptive function of the small intestine in liver cirrhosis

Cited by 69 publications

References 35 publications

Medium and long chain fat absorption in patients with cirrhosis.

Medium and long chain fat absorption in patients with cirrhosis.

Gastroenteric Clearance of Albumin in Liver Cirrhosis; Relative Protein-losing Gastroenteropathy

Histological abnormalities of the small bowel mucosa in cirrhosis and portal hypertension

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