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https://hdl.handle.net/2440/9011
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Type: | Journal article |
Title: | Malabsorption and villus atrophy in patients receiving enteral feeding |
Author: | Cummins, A. Chu, G. Faust, L. Chandy, G. Argyrides, J. Robb, T. Wilson, P. |
Citation: | Journal of Parenteral and Enteral Nutrition, 1995; 19(3):193-198 |
Publisher: | SAGE Publications |
Issue Date: | 1995 |
ISSN: | 1941-2444 1941-2444 |
Statement of Responsibility: | Adrian Cummins, Geoff Chu, Logan Faust, George Chandy, John Argyrides, Trevor Robb, and Peter Wilson |
Abstract: | Background: The purpose of this study was to assess the structure and function of the small intestine before and after enteral feeding given via a percutaneous feeding gastrostomy (PEG). It is not known whether this method of feeding provides a good luminal drive to the small intestine. Methods: Studies were performed of patients at the time of PEG placement, in a cross-sectional group after a period of feeding and in a smaller longitudinal subgroup. Enteral feeds were adjusted in volume and caloric content for each patient. Duodenal biopsies were taken during endoscopy for quantitative morphometry, and lactulose-rhamnose permeability tests were performed during the next day. Duodenal fluid was cultured quantitatively in the first study, and disaccharidases determined in the second study. Results: The first study of 15 patients, who had enteral feeding for a median (range) period of 13 (8 to 104) weeks, showed partial villous atrophy with normal crypt length, no increase in duodenal bacteriology, and abnormal lactulose-rhamnose sugar permeability due to rhamnose malabsorption. These changes were also present in 38 similar patients before enteral feeding. A second study before enteral feeding showed lowered maltase activity (24 patients), and similar intestinal permeability findings (22 patients). Twelve of these patients were followed longitudinally for 3 months of enteral feeding that maintained but did not improve nutrition, as assessed by body mass index and mid-arm muscle circumference, and there was no change in duodenal morphometry (11 patients), rhamnose malabsorption (4 patients), or disaccharidases (11 patients). Conclusions: These studies suggest villous atrophy was not due to an inflammatory enteropathy but resulted from a poor luminal "drive" associated with the enteral feeding. Enteral feeding maintained but did not improve nutrition status. |
Keywords: | Intestinal Mucosa Intestine, Small Duodenum Humans Malabsorption Syndromes Atrophy alpha-Glucosidases Rhamnose Lactulose Enteral Nutrition Longitudinal Studies Cross-Sectional Studies Intestinal Absorption Time Factors Nutritional Physiological Phenomena |
Rights: | © 1995 by The American Society for Parenteral and Enteral Nutrition |
DOI: | 10.1177/0148607195019003193 |
Appears in Collections: | Aurora harvest 4 Medicine publications |
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