Anorexia and malnutrition in patients with obstructive jaundice

Padillo, Francisco J.; Andicoberry, B; Pera-Madrazo, C; Sitges‐Serra, Antonio

doi:10.1016/s0899-9007(02)00982-6

Cited by 7 publications

(6 citation statements)

References 52 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our results confirmed observations made in previous studies[ 1 , 2 , 4 , 5 ] that patients with biliary obstruction, and especially those with malignant etiology, generally have worse nutritional indicators compared to healthy controls. To the best of our knowledge, this is the first study to prove elevated ghrelin concentrations in patients with biliary obstruction.…”

Section: Discussionsupporting

confidence: 92%

“…Unacylated ghrelin was not measured due to the biochemical reagent being unavailable at the time of the study. Since we had very limited data on CCK and ghrelin changes in this specific population, we have decided to increase a follow-up period bearing in mind the results of the only available study (6 d, Padillo et al [ 5 ]), but our results have shown that even a period of 28 d follow-up was too short to observe the complete dynamics of these hormones following a resolution of biliary obstruction.…”

Section: Discussionmentioning

confidence: 99%

“…Regardless of the underlying pathology, the blockage of bile ducts causes accumulation of bilirubin and bile salts in the blood and can lead to complications such as acute cholangitis, sepsis, liver dysfunction, renal failure, and cardiovascular impairment[ 1 , 3 ]. Malnutrition is common in patients with biliary obstruction with the prevalence of malnutrition in this population being up to 80% according to some studies[ 5 - 7 ]. Since malnutrition is associated with significant morbidity and mortality[ 8 - 10 ], it is important to identify factors and mechanisms involved in development of malnutrition in patients with biliary obstruction.…”

Section: Introductionmentioning

confidence: 99%

“…Tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6) are inflammatory cytokines associated with negative energy balance and cachexia[ 11 , 12 ]. Previous studies have found increased levels of both TNF-α and IL-6 in patients with biliary obstruction[ 1 , 2 , 5 ]. Cholecystokinin (CCK) is a gut derived hormone that inhibits food intake in humans[ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Gut peptide changes in patients with obstructive jaundice undergoing biliary drainage: A prospective case control study

Pavić¹,

Pelajić²,

Blažević³

et al. 2022

WJCC

View full text Add to dashboard Cite

BACKGROUND Biliary obstruction is a relatively common condition that affects approximately 5 in 1000 people annually. Malnutrition is very common in patients with biliary obstruction and since it is associated with significant morbidity and mortality, it is important to identify factors and mechanisms involved in its development. AIM To determine the influence of obstructive jaundice on the hormones controlling appetite and nutritive status. METHODS This was a prospective case control study performed in a tertiary center in Zagreb, Croatia. Patients with biliary obstruction undergoing internal biliary drainage from September 2012 until August 2013 were enrolled. After excluding patients who developed procedure related complications or were lost in the follow-up, out of initial 73 patients, 55 patients were included in the analysis, including 34 with benign and 21 with malignant disease. Meanwhile, 40 non-jaundiced controls were also included. Appetite, nutritional status, and serum ghrelin, cholecystokinin (CCK), interleukin 6 (IL-6), and tumor necrosis factor α (TNF-α) were determined at admission, 48 h and 28 d after internal biliary drainage. Chi square test was used for categorical variables. Continuous variables were analysed for normality by Kolmogorov–Smirnov test and relevant non-parametric (Mann-Whitney, Kruskal-Wallis, and Friedman) or parametric ( t -test and analysis of variance) tests were used. RESULTS Patients with obstructive jaundice were significantly malnourished compared to controls, regardless of disease etiology. Plasma ghrelin and CCK levels were significantly higher in patients with obstructive jaundice. Serum bilirubin concentrations were negatively correlated with ghrelin levels and positively correlated with TNF-α, but had no correlation with CCK concentrations. After internal biliary drainage, a significant improvement of nutritional status was observed although serum concentrations of ghrelin, IL-6, and TNF-α remained significantly elevated even 28 d after the procedure. CCK levels in patients without malnutrition remained elevated 28 d after the procedure, but in patients with malnutrition, CCK levels decreased to levels comparable with those in the control group. We have not established any correlation between appetite and serum levels of ghrelin, CCK, IL-6, and TNF-α before and after biliary drainage. CONCLUSION Possible abnormalities in ghrelin and CCK regulation may be associated with the development of malnutrition during the inflammatory response in patients with biliary obstruction.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Gut peptide changes in patients with obstructive jaundice undergoing biliary drainage: A prospective case control study

Pavić¹,

Pelajić²,

Blažević³

et al. 2022

WJCC

View full text Add to dashboard Cite

show abstract

“…TPN is associated with impairment of biliary secretion and cholestasis [23], which were evidenced by dramatically increased serum TB, DB, IB, ALP, and GGT levels in patients at baseline. In addition, dehydration and malnutrition also lead to cholestasis [24, 25]. Cumulatively, patients with high-output upper EF are at high risk of cholestasis.…”

Section: Discussionmentioning

confidence: 99%

Fistuloclysis Improves Liver Function and Nutritional Status in Patients with High-Output Upper Enteric Fistula

Ren

Wang

et al. 2014

Gastroenterology Research and Practice

View full text Add to dashboard Cite

Background. We aimed to determine the efficacy of fistuloclysis in patients with high-output upper enteric fistula (EF). Methods. Patients were assigned into the fistuloclysis group (n = 35, receiving fistuloclysis plus total enteral nutrition (TEN)) and the control group (n = 60, receiving TEN). Laboratory variables were measured during the four-week treatment. Results. At baseline, variables were similar between the two groups. Delta value was defined as the changes from baseline to day 28. Compared with the control group, the fistuloclysis group showed greater improvements in liver function (Delta total bilirubin (TB): 20.3 ± 9.7 in the fistuloclysis group versus 15.6 ± 6.3 in the control group, P = 0.040; Delta direct bilirubin (DB): 12.5 ± 3.4 versus 10.0 ± 3.6, P = 0.011; Delta alkaline phosphatase (ALP): 98.4 ± 33.5 versus 57.6 ± 20.9, P < 0.001); nutritional status (Delta total protein: 21.8 ± 8.7 versus 10.7 ± 2.1, P < 0.001; Delta albumin: 11.3 ± 2.5 versus 4.2 ± 1.3, P < 0.001). In the fistuloclysis subgroups, biliary fistula patients had the maximum number of variables with the greatest improvements. Conclusions. Fistuloclysis improved hepatic and nutritional parameters in patients with high-output upper EF, particularly in biliary fistula patients.

show abstract

Nutritional risk index predicts a high-risk population in patients with obstructive jaundice

et al. 2006

View full text Add to dashboard Cite

Anorexia and malnutrition in patients with obstructive jaundice

Cited by 7 publications

References 52 publications

Gut peptide changes in patients with obstructive jaundice undergoing biliary drainage: A prospective case control study

Gut peptide changes in patients with obstructive jaundice undergoing biliary drainage: A prospective case control study

Fistuloclysis Improves Liver Function and Nutritional Status in Patients with High-Output Upper Enteric Fistula

Nutritional risk index predicts a high-risk population in patients with obstructive jaundice

Contact Info

Product

Resources

About