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Hypophosphatemia is a rare ionic alteration that occurs mainly in hospitalized patients. It is estimated that up to 5 percent of them may have low serum phosphate concentrations (less than 2.5 mg / dL [0.80 mmol / L]). However, prevalences greater than 30 to 50 percent have been reported in alcoholic patients and/or patients with severe sepsis or trauma (1,2). When combined with phosphate depletion (that is, when it is not due solely to phosphate movement into cells), hypophosphatemia can cause a variety of signs and symptoms, primarily symptomatic when it is less than 1 mg / dL (3). The leading causes are divided into four points according to their production mechanism: internal redistribution, decreased intestinal absorption, increased urinary excretion, or elimination through renal replacement techniques (4). We present the case of a patient suffering from unspecific acute encephalopathic symptoms associated with severe hypophosphatemia with adequate evolution after its correction. [ABSTRACT FROM AUTHOR]

Objective: Intestinal failure refers to a reduction in intestinal function that necessitates intravenous supplementation of macronutrients, water, or electrolytes due to the intestine's inability to absorb these substances adequately to maintain health and growth. This study aims to explore the experiences and challenges faced by patients enrolled in the intestinal rehabilitation program at Hospital Pablo Tobón Uribe in Medellín. Methodology: This qualitative study adopts a hermeneutic approach and utilizes grounded theory techniques. The sampling process involved both selective and theoretical sampling. A total of 20 semi-structured interviews were conducted, with eight interviews including contributions from family members. The data analysis commenced with open coding, followed by the grouping of codes into descriptive categories. Dimensions and properties were identified within these categories, and analytical categories were subsequently developed through axial and selective coding. This iterative process led to the emergence of the final paradigm matrix. Results: The study revealed that the healthcare system inadequately addresses the needs and expectations of patients with intestinal failure, leading to increased uncertainty about the disease's origin and future prognosis. Intestinal failure and its treatment disrupt various aspects of patients' lives, including personal, family, and work domains. Social stigmatization and rejection are prominent, underscoring the importance of support from family and close individuals in facilitating adaptation and revaluing life. Conclusions: Coping with the challenges of intestinal failure entails embracing the necessity of relying on parenteral nutrition, which is perceived as a prison that paradoxically enables survival. [ABSTRACT FROM AUTHOR]

This work describes the effects of the probiotic Saccharomyces cerevisiae on the area, number of Lieberkühn crypts in the duodenum and jejunum, and mucus production in both intestinal sections. Tissues from a total of 27 individuals were used, classified in control group - GC (n = 12) and group supplemented with probiotics - GP (n = 15). The results revealed that the group supplemented with S. cerevisiae presented a greater area of the crypts in the duodenum (p = 0.0119) and jejunum (p = 0.0355), less number of crypts per millimeter in the duodenum (p = 0.0420) and higher mucus production in the duodenum compared to the control group (p = 0.0185), while in the jejunum no significant differences were observed. It was concluded that the use of Saccharomyces cerevisiae increased the size of the crypt area in both intestinal sections and increased mucus production in the duodenum; which by increasing the intestinal absorption surface could surely result in improvements in the productive parameters. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the antihyperglycemic potential of the Gentianella gilgiana (Reimers) Fabris ex J.S. Pringle infusion for in vitro intestinal glucose absorption in Rattus norvegicus of the Holtzman strain with chemically-induced diabetes. Materials and methods: The study had an experimental and analytical design. A phytochemical screening of the whole plant was carried out. For the in vitro study, twenty male albino rats were induced with diabetes using alloxan monohydrate (Sigma-Aldrich, Saint Louis, MO, USA) at a dose of 120 mg/kg bw administered by intraperitoneal route, and then randomly distributed into two groups of ten albino rats each. After ten days, they were sacrificed to extract an intestinal segment using the everted intestinal sac technique, and measure the glucose transport and absorption. In the control group (everted intestines incubated in Krebs-Henseleit solution containing glucose) and the experimental group (intestines incubated in Krebs-Henseleit solution containing glucose plus the Gentianella gilgiana (Reimers) Fabris ex J.S. Pringle infusion at 10% w/v), basal samples of fluids were taken from incubation, and then other samples were taken at 15, 30, 45 and 60 minutes to quantify the glucose from the mucous and serous compartments using the glucose oxidase enzymatic method. Results: Lower concentrations of absorbed glucose were observed in the intestinal serous compartment of the experimental group (G. gilgiana) with a statistically significant difference compared to the control group (p <0.05). Conclusions: The Gentianella gilgiana (Reimers) Fabris ex J.S. Pringle infusion exhibits a significant antihyperglycemic potential by decreasing the in vitro intestinal glucose absorption in diabetic albino rats. [ABSTRACT FROM AUTHOR]

The short bowel syndrome (SIC) is a complex entity characterized by a malabsorptive state usually secondary to extensive intestinal resection originating a clinical, metabolic and/or nutritional disorder due to the reduction of the effective intestinal absorptive surface. The diagnosis is essentially clinical and, due to the patients malabsorptive process, it requires nutritional support to maintain their basic requirements, as the case reported. The clinical features of SIC patients depend on the grade of the alteration of function of the the small intestine or the impairment secondary to the surgical resection. We know that electrolytes are absorbed predominantly in the proximal gut. The regulation of ion/mineral levels depend on both the intestinal absorption and the renal excretion. We present an unusual case of SIC with only low absortion of magnesium. We discuss the most outstanding aspects of the case and review the literature. [ABSTRACT FROM AUTHOR]

Proteins NPC1L1, ABCG5 and ABCG8 are involved in the intestinal absorption of cholesterol. Ezetimibe inhibits this process by blocking NPC1L1, however, its effect on ABCG5 and ABCG8 is not yet clear. Thus, the objective of this study was to evaluate in C57BL / 6 mice with diet-induced hypercholesterolemia treated with ezetimibe, the expression of NPC1L1, ABCG5 and ABCG8 by real time PCR and Western blot, in 3 groups of animals: 1, diet hypercholesterolemic D12336, 2, D12336 diet plus 5 mg/kg/ day of ezetimibe, 3, diet control. The serum level of total cholesterol was significantly different between groups (control: 1.85 ± 0.49 mmol / L; diet D12336: 3.11 ± 0.73 mmol / L; ezetimibe: 2.11 ± 0.50 mmol / L, P = 0.001). NPC 1 LI gene expression increased 5.4-fold in the group receiving the diet D12336 (P = 0.003). Furthermore, the gene expression of ABCG5 and ABCG8 was not different in the group with hypercholesterolemia (P = 0.239 and P = 0.201, respectively). After treatment with ezetimibe, ABCG5 gene expression was increased 15.6 times (P = 0.038). No significant differences in gene expression of NPC1L1 (P = 0.134) and ABCG8 (P = 0.067). Regarding protein expression, the D12336 diet increased the levels of expression of NPC1L1 (P = 0.022) and ABCG5 (P = 0.008), treatment with ezetimibe increased the levels of NPC1L1 (P = 0.048) and reduced levels of ABCG5 (P = 0.036) and ABCG8 (P = 0.016). In conclusion, our results suggest that both hypercholesterolemic diet as treatment with ezetimibe, in an experimental model, affect the expression levels of NPC1L1, ABCG5 and ABCG8, suggesting that ABCG5 and ABCG8 are involved in lipid-lowering response to this drug. However, the mechanism by which this interaction is explained requires further study. [ABSTRACT FROM AUTHOR]

Gastric cancer is a frequent cause of cancer-related mortality in the world. Surgery is the only potentially curative therapy, although the adverse effects of surgery are common and considerable. Common variable immunodeficiency is in many cases cause of gastrointestinal system problems such as chronic diarrhea caused by infestation with giardia lamblia, nodular lymphoid hiperplasia and loss of villi leading frequently to malabsorption and malnutrition. Nutritional deficiencies due to malabsorption (postgastrectomy and secondary to loss of villi, giardiasis and common variable inmunodeficiency) are common. We present the case of a patient with gastric cancer who underwent a gastrectomy with common variable hypogammaglobulinemia and chronic infestation by giardia lamblia, with serious diarrhea resistant to treatment and malabsorption. [ABSTRACT FROM AUTHOR]

Introduction: SBS is the main cause of intestinal failure (IF) in children and has a high morbidity and mortality. Objectives: to analyze factors associated with the outcome and survival of SBS children. Methods: analytical, descriptive and retrospective study. We include patients with residual bowel length (RBL) ≤ 40 cm. Outcome is analyzed in groups: dead (D), adapted (A), parenteral nutrition dependent (NPD), and transplanted (Tx) according to: bowel anatomy, diagnosis, prematurity, year of beginning of IF, duration of IF, cholestasis (CB > 2 mg/dl) and thrombosis. Survival is analyzed with Kaplan Meier. Results: 63 patients were included: RBL x 21 ± 11 cm, preserved colon 46%, prematures 41%, neonatal resection 78%, duration of IF x 0.66 years. 54% had cholestasis (CB × 5.29 ± 2.35 mg/dl) and 25% had thrombosis. Outcome:D 33%, A 27%, PND 30% and Tx 10%. Adapted patients had longer RBL (p 0.001) and more preserved colon (p 0.017). 1 year survival was 86%, 2 years 70% and 3 years 66%. Age at death: x 2.3 years. Causes of death: hepatic failure 62%, lack of venous access 19%, sepsis 10%, others 10%. Factors related to death were shorter RBL (p 0.045), cholestasis (0.049, admittance to the center before 2000 (p 0.02). Conclusions: SBS had a high mortality and 1/3 of patients could adapt requiring up to 5 years. Adaptation was in relation to anatomic factors. Mortality was related to. [ABSTRACT FROM AUTHOR]

Background & Aims: Short Bowel syndrome is a serious intestinal insufficiency. The most common etiology in adults nowadays is intestinal ischemia and inflammatory disease, while in children the most common are congenital anomalies, volvolus and necrotizing entero-colitis, which makes the TPN obligatory. However the intestine is intimately related to the liver through the entero-hepatic circulation and different endocrinological entero-hepatic systems. Massive intestinal resections and TPN would alter this relationship, and could change the hepatic tissue composition and its histomorphology. The aim of this work is to know these changes in more detail. Materials and methods: We used 3 experimental groups: Group A (10 guinea pigs), which was given anesthetic and a simple laparotomy and fed for 10 days with NPT. Group A (10 guinea pigs), underwent total thin intestine resection and were fed for 10 days with NTP. The control group (6 guinea pigs) underwent anesthetic and a simple sham laparotomy and were fed orally. After this period blood and hepatic tissue samples were taken in order to study the liver fat (total fat, proportion of neutral and polar lipids, proportion of phospholipids and fatty acids). Liver biopsies were taken and studied under an optical microscope. Results: The animals from group A and B, underwent NPT, showed a significant increase in glycémie and serum triglycerides, decreasing the cholesterol in GB. There was a significant decrease in weight and in the proportion of fat per g of the liver tissue, at a maximum level in GB, and an even higher decrease in the LP/LN ratio in GA and GB. There was also a change in the proportion of phospholipids, decreasing the Phosphatidili-nositol and increasing the Phosphatidiletanolamine. There was also a decrease in the AG w6/w3 ratio. Histologically appear a steatohepatitys, with a striking decrease in the mitochondrial density, being more intensive in GB. Conclusions: NPT alters the composition of the hepatic fat and the hystomorphology of the liver. The short bowel syndrome have more lesional mechanisms, favouring the hepatic damage caused by NPT. [ABSTRACT FROM AUTHOR]

Amino acid ileum digestibility is one of the most important factors to determine the nutritional value of foods. However, the values obtained in ileum digestibility tests can vary according to the endogenous nitrogen losses in the animal. Thus, ileum digestibility values can be classified as apparent or true. When determining the apparent value, endogenous nitrogen losses are not taken into account and the amounts of absorbed amino acid during digestion are then underestimated. When the endogenous component is taken into account, digestibility data become true, being the best parameter to represent absorbed amino acid in the digestive tract. Endogenous nitrogen losses are classically defined as the nitrogen found in the digesta or in the feces of animals fed with nitrogen-free diets. Traditionally, endogenous nitrogen losses in pigs have been determined by feeding nitrogen-free diets or by the lineal regression method. More recently, several alternative techniques have been developed to evaluate endogenous nitrogen losses in pigs that are fed with diets that contain variable protein levels. Each of these techniques has some limitations and all require different assumptions. Based on the increasing number of results recently obtained with different techniques, endogenous nitrogen losses seem to be highly affected by the used method and by factors as weight, dry matter consumption, and diet components (anti nutritional factors, fiber and protein) [ABSTRACT FROM AUTHOR]

Many patients with chronic alcohol abuse present a clinical picture of malnourishment either because of reduced usual intake of essential nutrients or because alcohol precludes an appropriate digestion and absorption of the different essential elements, vitamins, and minerals. A usual example is vitamin A deficiency in these patients. Besides, ethanol metabolic pathways themselves (through the ADH and the MEOS system) generate toxic intermediate products (acetaldehyde, free radicals) interfering with normal metabolism of essential elements, mainly lipids, leading to cellular damage through lipid peroxidation mechanisms and impairment of the membrane fluidity, fat deposits (hepatocellular esteatosis), inflammation secondary to oxidative stress and proinflammatory cytokines, activation of stellate cells, fibrogenesis, etc. Nutritional supports may be effective to improve alcoholic liver disease. A balanced diet, vitamin supplements, and pharmacological therapy with antioxidants in order to recover depleted glutathione deposits are recommended. It is paramount that these patients have a multidisciplinary clinical approach to resolve the problem of alcohol dependency. [ABSTRACT FROM AUTHOR]

The short bowel syndrome (SBS) is a complex entity due to anatomical or functional loss of part of the small bowel originating a clinical picture with severe metabolic and nutritional impairments due to reduction of the effective absorptive surface area of the gut. SBS is one of the causes of a larger entity known as "intestinal failure". Currently, mesenteric vascular accidents are the main cause in adults, followed by inflammatory bowel disease, and radiation enteritis, whereas in children, the main causes are congenital and perinatal diseases. The clinical picture associated with SBS varies according to the length and location of affected small bowel, the presence of underlying disease, the presence or absence of the large bowel and ileocecal valve, and the nature of the underlying disease. Intestinal adaptation is the process by which, throughout 1-2 years, intestinal absorption is reestablished to the situation prior to intestinal resection, and is a key factor determining whether a patient with SBS will progress to intestinal failure and depend on DPN. Intestinal adaptation may take place if the patient does oral intake higher than the usual one (hyperphagia); besides, the bowel may also adapt to secure a more effective absorption per surface area unit, either by increasing the absorptive surface area (structural adaptation) and/or slowing intestinal transit (functional adaptation). These changes are not still clearly established in humans, but there are so in animal models. The presence of nutrients within the intestinal lumen and certain gastrointestinal hormones, particularly GLP-2, have an influence on a successful adaptation process. Patients with SBS are prone to the occurrence of bacterial overgrowth that makes adaptation difficult and worsens the symptoms, besides being a factor for dependence on parenteral nutrition. [ABSTRACT FROM AUTHOR]

The human intestine is a complex and variable in lenght organ, oscillating between 3 and 8 metres, depending on the individual characteristics and the techniques used to measure it. The main function of the intestine is to get a suitable incorporation of food into the body and this is carried out by menas of the digestion and food absorption processes. When these functions fail, Maldigestion and Malabsorption appear. These have characteristic clinical data and must be studied with the help of specific techniques for every digestive step and every food (fat malabsorption, proteins and carbohydrates tests). [ABSTRACT FROM AUTHOR]

Objective: To compare nutritional status and intestinal absorption in asymptomatics HIV patients co-infected or not with hepatitis C virus. Material and methods: 15 patients (9 men and 6 women) HIV seropositive in AI-A2 stage were classified in two groups, A were asymptomatics HIV patients and B were asymptomatic H1V patients with chronic hepatitis C. Nutritional status was determined by weight, height, % ideal weight, body mass index, triceps skinfold, mid-arm muscle circumference, grip dynamometry and body composition measured by bioelectrical impedance. Intestinal absorption was assesses with D-xilosa test in urine collected over 5 hours after fasting ingestion of 5 grams of D-xylosa. Statistical analysis was made with SPSS (v.11.0). Results: Not statistically significative differences were found in the nutritional status between the two groups of patients. Asymptomatics HIV patients with chronic hepatitis C eliminate less D-xylosa in urine than patients without chronic hepatitis C, being this difference statistically significative. Three out of the eight patients (37,5%) of group B presented malabsorption (< 1,2 grams of D-xylosa in urine). In group A any patient had malabsorption. Discusion: In our study, asymptomatic HIV patients have a good nutritional status, without differences between patients co-infected or not with hepatitis C virus. Intestinal absorption is altered in patients co-infected and this should be considered because of its potential clinical consequences. [ABSTRACT FROM AUTHOR]

Resection of long segments of the small bowel may cause variable degrees of malabsorption. Therefore, the results of the resection will depend on the length and location of the resected segment, and on the age of the patient and the underlying disease that motivated the resection. The implementation of Nutritional Support after intestinal resection is the main stimulating factor for adaptation of the remnant bowel and is important to prevent hyponutrition. The relevance of this case is due to the fact that our 87 years old patient has a good nutritional status and good quality of life 10 years after resection was performed, his remnant bowel having adapted to physiological functions. [ABSTRACT FROM AUTHOR]