Common Pitfalls in the Management of Patients with Micronutrient Deficiency: Keep in Mind the Stomach

Carabotti, Marilia; Annibale, Bruno; Lahner, Edith

doi:10.3390/nu13010208

Cited by 28 publications

(24 citation statements)

References 141 publications

(188 reference statements)

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“…Those conditions result in a profound inhibition of gastric acid, and intrinsic factor secretion leads to a state of selective malabsorption of vitamin B12. Such is the case with autoimmune atrophic chronic gastritis, a cause of pernicious anemia [37].…”

Section: Diminished Intrinsic Factormentioning

confidence: 99%

Small and Large Intestine (I): Malabsorption of Nutrients

2021

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Numerous disorders can alter the physiological mechanisms that guarantee proper digestion and absorption of nutrients (macro- and micronutrients), leading to a wide variety of symptoms and nutritional consequences. Malabsorption can be caused by many diseases of the small intestine, as well as by diseases of the pancreas, liver, biliary tract, and stomach. This article provides an overview of pathophysiologic mechanisms that lead to symptoms or complications of maldigestion (defined as the defective intraluminal hydrolysis of nutrients) or malabsorption (defined as defective mucosal absorption), as well as its clinical consequences, including both gastrointestinal symptoms and extraintestinal manifestations and/or laboratory abnormalities. The normal uptake of nutrients, vitamins, and minerals by the gastrointestinal tract (GI) requires several steps, each of which can be compromised in disease. This article will first describe the mechanisms that lead to poor assimilation of nutrients, and secondly discuss the symptoms and nutritional consequences of each specific disorder. The clinician must be aware that many malabsorptive disorders are manifested by subtle disorders, even without gastrointestinal symptoms (for example, anemia, osteoporosis, or infertility in celiac disease), so the index of suspicion must be high to recognize the underlying diseases in time.

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Section: Diminished Intrinsic Factormentioning

confidence: 99%

Small and Large Intestine (I): Malabsorption of Nutrients

2021

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“…In our scale, we developed the dimension "health condition and eating habits", which included two items: "Suffer from diarrhea, constipation and/or chronic gastric diseases" and "High study pressure, fast and irregular eating habits". The unhealthy state of digestive system, eating disorders, and unhealthy eating habits reduce digestion and absorption of nutrients and lead to micronutrient deficiency and malnutrition [52][53][54][55][56][57]. In summary, the results indicate that the HHAS-HSS presents good reliability and validity among high school students in Anhui Province, China, and is a new and effective tool for assessing the risk of hidden hunger.…”

Section: Discussionmentioning

confidence: 86%

Reliability and validity of the hidden hunger assessment scale for Chinese high school students

Zhang

Wang

Zhang

et al. 2022

Preprint

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Background: Hidden hunger, also known as insufficient micronutrient intake, is still a severe public health problem, affecting over 2 billion people worldwide. High school students are in an important stage of growth and development. Due to huge academic stress, high school students often lack nutrition knowledge and have unhealthy eating habits, suggesting a higher risk for hidden hunger. However, information on the hidden hunger risk of high school students is limited, and tools for assessing hidden hunger are inadequate. Objectives: To revise the hidden hunger assessment scale for high school students (HHAS-HSS) in China and assess its reliability and validity. Methods: Based on the literature review, expert consultation, pre-experiment, and formal survey, a hidden hunger assessment scale was revised for high school students. The formal survey involved 9,336 high school students in 11 of the 16 cities in Anhui Province, China, from 1 September 2020 to 31 December 2020, and 9,038 valid questionnaires were collected and included in the analysis. The item analysis, internal consistency reliability, test-retest reliability, content validity, exploratory factor analysis, and confirmatory factor analysis of the HHAS-HSS were examined. Results: The HHAS-HSS included a total of 4 dimensions and 12 items: vegetables and food diversity (3 items), fruits and dairy products (3 items), micronutrient-dense foods (4 items), and health condition and eating habits (2 items). The results showed a Cronbach's alpha of 0.758, a split-half reliability of 0.829, and a test-retest reliability of 0.793, indicating good internal consistency. The exploratory factor analysis presented a four-factor model of the HHAS-HSS (KMO=0.820, P<0.001). Using the maximum variance rotation method, 4 factors were obtained, and the cumulative variance explained rate was 57.974%. Confirmatory factor analysis also supported the division of the scale into four dimensions and the above results showed that the construct validity of the scale has reached an acceptable level. Conclusions: The HHAS-HSS is an effective and convenient tool for the assessment of hidden hunger with good reliability and validity.

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“…Gastric cancer mainly occurs in gastric antrum and distal lesser curvature of stomach. After distal gastrectomy, iron absorption and endogenous factor secretion of gastric parietal cells decreased 14 . The described situation will lead to anemia in patients, and then the blood carrying capacity of the patients will be weakened 15 .…”

Section: Discussionmentioning

confidence: 97%

Effects of different gastrointestinal reconstruction techniques on nutrition, anemia, and quality of life in laparoscopic distal gastrectomy for gastric cancer

Shan

et al. 2022

Acta Cir. Bras.

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To explore the effect of different gastrointestinal reconstruction techniques on laparoscopic distal gastrectomy of gastric cancer on the nutritional and anemia status, and quality of life (QoL) of patients. Methods: Eligible patients were randomly divided into three groups (n=36/group): Billroth I anastomosis group, Billroth II combined with Braun anastomosis group, and Roux-en-Y anastomosis group. Related indicators were compared and analyzed. Results: The general data were comparable among the three groups (all P>0.05). Among the surgical-related indicators and postoperative recovery indicators, only the comparison of the operation time was statistically significant (P=0.004). The follow-up time was 5~36 months (average 27.9 months). In terms of nutritional and anemia indicators, only the differences in the levels of prealbumin, hemoglobin and serum ferritin in 24 months after operation showed significant differences (P=0.015, P=0.003, P=0.005, respectively). There were no significant differences in hospital readmission rate, overall survival, and QoL among the three groups (all P>0.05). Conclusion:In laparoscopic gastrectomy for stage II~III distal gastric cancer, Billroth I anastomosis has shorter operation time than Billroth II combined with Braun anastomosis and Roux-en-Y anastomosis and advantages in the improvement of nutritional status and anemia recovery.

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Common Pitfalls in the Management of Patients with Micronutrient Deficiency: Keep in Mind the Stomach

Cited by 28 publications

References 141 publications

Small and Large Intestine (I): Malabsorption of Nutrients

Small and Large Intestine (I): Malabsorption of Nutrients

Reliability and validity of the hidden hunger assessment scale for Chinese high school students

Effects of different gastrointestinal reconstruction techniques on nutrition, anemia, and quality of life in laparoscopic distal gastrectomy for gastric cancer

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