Biomedical subjects

A B Thomson

Publications and source records attributed to A B Thomson.

At least 271 records · Page 15Linked to original sources

PubMed1985

Interrelationship between gastric acidity and gastrin concentration in patients with duodenal or gastric ulcer and in healthy subjects.

Although increased gastric acidity may be important in the pathogenesis of duodenal ulcer, it has a less well-defined role in the formation of gastric ulcers. The present study was undertaken to determine (1) the 24-hour intragastric pH and serum gastrin profiles of 31 patients with duodenal ulcers, eight patients with gastric ulcers, and seven healthy volunteers and (2) the effect of 600 mg of cimetidine BID on these measurements. There was considerable overlap of basal acid output values in the three groups, and mean values did not differ significantly. In response to pentagastrin, the peak acid output was significantly higher in the duodenal ulcer group than in the gastric ulcer or healthy group. There were no intergroup differences in intragastric hydrogen ion (H+) activity after meals, overnight, and over 24 hours, when all subjects received placebo. However, the pH values remained at or above 4.0 for a longer period during the night in the gastric ulcer patients than in the duodenal ulcer patients or healthy subjects. There were no intergroup differences in basal gastrin concentration, but the postprandial gastrin response after each meal was higher in the gastric ulcer group than in the other two groups. In the gastric ulcer group, cimetidine suppressed H+ activity at all times; in the duodenal ulcer and healthy groups, cimetidine suppressed H+ activity only after breakfast, overnight, and over 24 hours. Cimetidine enhanced the serum gastrin response to food to a greater extent in the ulcer patients than in the healthy subjects. In the healthy subjects, the ratio of H+ to gastrin (H+:G) was higher than in the duodenal or gastric ulcer patients but was suppressed only minimally by cimetidine, whereas cimetidine markedly suppressed the H+:G ratio in both groups of ulcer patients. Patients with a history of duodenal or gastric ulcers differed from healthy volunteers in their food-stimulated gastrin response and in their H+:G ratio when treated with cimetidine. Intergroup differences in gastrin response to food, but not in intragastric pH in response to food, suggests that defective control of or response to gastrin may be important in the pathogenesis of acid-peptic disease. Cimetidine, which was effective in H+ suppression in all subject groups, may alter the sensitivity of the parietal cells to gastrin in patients with duodenal or gastric ulcers.

Adult↗

PubMed1985

Nutritional status of gastroenterology outpatients: comparison of inflammatory bowel disease with functional disorders.

Dietary intakes of two groups of gastrointestinal patients, one group with inflammatory bowel disease (IBD)--Crohn's disease or chronic ulcerative colitis--and the other with functional disorders (FD)--irritable bowel syndrome, nonulcer dyspepsia, or gastroesophageal reflux disease, were assessed by means of 48-hour recalls. The relationships between dietary intake and anthropometric and biochemical measurements were examined. The IBD group had lower mean serum albumin and hemoglobin levels (p less than .05); however, FD patients had less adequate diets. The mean energy intake of women with FD was significantly lower than that of women with IBD (p less than .05) and was associated with inadequate or marginal intakes of many nutrients. Comparison of nutrient intakes between the IBD and FD groups revealed a significantly lower mean intake of folate, ascorbic acid, and vitamin A for women with FD than for women with IBD (p less than .05). In general, women had poorer diets and a higher prevalence of abnormal biochemical parameters than men. One notable feature of the dietary pattern of the women was that they consumed less meat than the general population consumed. Increasing meat consumption would improve the intake of many nutrients, including protein and iron. The results of this study suggest that more attention should be given to the adequacy of dietary intakes of gastrointestinal patients in general and of women in particular.

Adult↗

PubMed1985

Effect of two defined formula diets on jejunal and colonic uptake of hexoses in control and ileal resected rabbits.

An in vitro technique was used to measure the jejunal and colonic uptake of glucose and galactose in sham-operated control (CONT) rabbits and in animals with a surgical resection of the distal half of the small intestine (RES) performed six weeks previously. CONT and RES were fed ad libitum or pair-fed amounts of standard Purina chow, or ad libitum amounts of Ensure or Flexical HN for two weeks. Flexical NH differs from Ensure in its higher content of carbohydrate, essential fatty acids and polyunsaturated fatty acids but lower total dietary content of fat. The ad libitum chow-fed animals gained weight whereas the animals fed the defined formula diets lost weight. Weight gain was greater in RES than CONT fed chow, and weight loss was greater in RES than CONT fed Ensure or Flexical HN. Despite these differences in body weight, the dry and wet weights of the jejunum, and the adherent mucosal fluid volumes remained unchanged in CONT and RES fed the different diets. The intestinal morphology was unaffected by feeding Ensure or Flexical HN to control animals, whereas the villus cell size, villus and mucosal surface areas were lower in resected rabbits fed these diets than in resected animals fed chow. Glucose uptake was greatest in CONT and RES fed Flexical HN. Glucose uptake was higher in RES than CONT fed chow or Ensure but was lower in RES than CONT fed Flexical HN. In CONT fed Flexical HN, there was a lower value of the apparent Michaelis constant, Km*, and a higher value of the apparent passive permeability coefficient (Pd*) than in animals fed chow or Ensure. In RES there was lower Pd* in Ensure and Flexical HN-fed rabbits than in those fed chow, but the Km* was lower and the maximal transport rate, Jdm, was higher in animals given Flexical HN. The colonic uptake of glucose and the jejunal uptake of galactose was also influenced by feeding Ensure and Flexical HN. These differences in uptake in animals fed Ensure or Flexical-HN could not be explained by differences in body weight gain, since a different pattern of changes in glucose and galactose uptake was observed in CONT or RES rabbits exposed to restricted chow intake.(ABSTRACT TRUNCATED AT 400 WORDS)

Adaptation, Physiological↗

PubMed1984

Acute exposure of rabbit jejunum to ethanol. In vitro uptake of hexoses.

The effect of acute exposure of rabbit jejunum to ethanol on the uptake of three hexoses was examined in vitro. With ethanol present in the preincubation medium for 30 min, or directly in the incubation medium for 6 min, glucose uptake was reduced. Kinetic analysis demonstrated that ethanol in the preincubation medium was associated with a rise in the value of the apparent Michaelis constant (Km*), whereas the inhibition of glucose uptake observed with ethanol present directly in the incubation medium was associated with a reduction in the apparent passive permeability coefficient (Pd*), a reduction in the maximal transport rate (Jdm), and an increase in Km*. When increasing concentrations of ethanol were added to the preincubation or to the incubation medium, there was a reduction in the uptake of both 1 mM and 40 mM glucose, galactose, and 3-O-methyl glucose. The addition of 40 mM galactose or 1 mM phloridzin to 40 mM glucose was associated with a 50% reduction in glucose uptake, but this uptake was not further inhibited by the addition of 6% ethanol (v/v). Similarly, the uptake of 3-O-methyl glucose was inhibited by the addition of 40 mM glucose or galactose but no further reduction in uptake was achieved by adding ethanol. Finally, galactose uptake was inhibited by adding 40 mM glucose or 40 mM 3-O-MG, but the addition of 6% ethanol was associated with no further decline in the uptake of galactose.(ABSTRACT TRUNCATED AT 250 WORDS)

3-O-Methylglucose↗

PubMed1984

Effect of ethanol on intestinal uptake of fatty acids, fatty alcohols, and cholesterol.

The effect of acute exposure of the rabbit jejunum to ethanol on the uptake of fatty acids, fatty alcohols, and cholesterol was examined using a previously validated in vitro technique. The effective resistance of the intestinal unstirred water layer was determined from the rate of uptake of a homologous series of fatty alcohols. The addition of ethanol to the incubation or preincubation solutions had no effect on the uptake of these probes when the bulk phase was stirred at 600 rpm, but uptake was higher in the ethanol-exposed samples when the bulk phase was unstirred. Increasing the concentration of ethanol in the bulk phase was associated with a progressive decline in the rate of uptake of acetic, lauric, myristic, and palmitic acids, whereas the uptake of hexanoic, octanoic, and decanoic acids was unaffected, and the uptake of cholesterol was increased. Acute exposure of the intestine to ethanol was associated with an increase in the electrical conductance of the tissue, with no associated change noted in the tight junctions on transmission electron microscopy or in the surface epithelium on scanning electron microscopy. The results suggest that acute exposure of the rabbit intestine to ethanol is associated with a selective decline in the passive permeability properties of the membrane towards only certain lipids and that the effective resistance of the unstirred layer is influenced by ethanol only when the bulk phase is unstirred and the resistance is high.

Animals↗

PubMed1984

Effect of external abdominal irradiation on the dimensions and characteristics of the barriers to passive transport in the rat intestine.

Limited information is available on the effect of irradiation on the intestinal absorption of passively transported nutrients. In this study a previously validated in vitro technique was used to measure the uptake of fatty acids (FA), fatty alcohols and cholesterol into the jejunum, ileum and colon of control rats and animals exposed to cesium-137 source irradiation applied to the abdomen. The effective resistance of the intestinal unstirred water layer was measured with lauryl alcohol, and in control rats this resistance was lowest in the ileum, highest in the colon, and of intermediate value in the jejunum. Fourteen days after 600 rads, unstirred layer resistance was reduced by half in the colon when the bulk phase was stirred at 600 rpm, and in the jejunum, ileum and colon when the bulk phase was unstirred (0 rpm). The incremental change in the free energy of transfer (integral of delta Fw----l) was measured with a homologous series of saturated medium-chain length fatty acids; 14 days after 600 and 900 rads the value of integral of delta Fw----l in the jejunum rose significantly, and occurred when light and electron microscopic changes were minimal. Fourteen days after 300 rads, the uptake of FA 6:0-12:0 was reduced, but this decline in uptake appeared to be caused by a fall in the functional surface area of the membrane rather than a change in integral of delta Fw----l. The uptake of cholesterol into the jejunum, ileum and colon was unaffected by irradiation, suggesting that cholesterol and fatty acids may have different diffusion pathways through the membrane. Thus, external abdominal irradiation influences the dimensions and characteristics of the barriers to passive transport in the intestine of the rat, and thereby modifies the uptake of some but not all passively absorbed nutrients. These functional changes are not closely associated with morphological alterations.

Animals↗

PubMed1984

Intestinal uptake of bile acids: effect of external abdominal irradiation.

Abdominal irradiation has recently been shown to influence the uptake of hexoses, amino acids, fatty acids and cholesterol into the jejunum of rats. The present studies were undertaken with a previously validated in vitro technique to determine the effect of abdominal irradiation from a cesium 137 source on the rates of uptake of six bile acids into the jejunum, ileum, and colon. In the ileum of control rats, there were marked differences in the value of the apparent Michaelis constant (Km*), maximal transport rate (Jdm), and apparent passive permeability coefficient (Pd*) between cholic (C), glycocholic (GC), taurocholic (TC), chenodeoxycholic (CDC), and glycochenodeoxycholic (GCDC), and deoxycholic (DC) acid. The Km* for each bile acid except DC was lower three and 14 days after 600 rad, whereas the Jdm for GC fell, but rose for TC, CDC, GCDC and DC and was unchanged for C. The Pd* rose for C, GC, and DC, fell for TC and CDC, but remained unchanged for GCDC 14 days after irradiation. After 600 rad the value of Pd* in the colon was increased at day 3 and 14 for CDC and GCDC, but was unchanged for GC and TC and was decreased for C. The uptake of bile acids was also affected by 300 rad and by 900 rad, but the direction and magnitude of the change was influenced by the intestinal site, the dose of irradiation, and the type of bile acid. The results show that: 1) there likely are multiple ileal carriers for bile acids; 2) abdominal irradiation has a variable effect on these carriers; 3) the passive permeability to bile acids varies with the bile acid and with the site along the intestine; and 4) abdominal irradiation is associated with a rise in the colonic permeability to only some bile acids.

Abdomen↗

PubMed1984

Effect of region of intestine and unstirred layers on uptake of sugars into rabbit intestine.

The kinetic characteristics of the transport of four sugars were determined in rabbit jejunum and ileum. The effective resistance of the intestinal unstirred layer and the rates of uptake of glucose, galactose, 3-O-methyl glucose and fructose were assessed in vitro. The unstirred layer resistance was higher in jejunum than in ileum at all rates of stirring of the bulk phase. The maximal transport rates, Jmd, of galactose and 3-O-methyl glucose were higher than the Jmd of glucose, which in turn was higher than that for fructose. The Jmd of glucose, galactose, and fructose were each lower in ileum than in jejunum, but the Jmd of 3-O-methyl glucose in the ileum was similar to both regions. For the single Michaelis-Menten model, the values of the Michaelis constant, Km, for glucose and galactose were slightly lower in the jejunum than in the ileum, whereas the value of the Km for 3-O-methyl glucose and for fructose were similar in the two sites. In the jejunum, the relative values of the Km were 3-O-methyl glucose = fructose greater than galactose greater than glucose. It is regarded that variations in sugar absorption between the jejunum and ileum are due to differences in the values of the effective resistance of the unstirred water layer, the maximal transport rate, and the Michaelis constant.

Animals↗

PubMed1984

Mechanisms of intestinal adaptation: unstirred layer resistance and membrane transport.

The effect of the resistance of unstirred water layers (UWL) on the kinetic parameters of active and passive intestinal transport processes is well established, but the possibility of adaptive changes in the resistance of this diffusion barrier in health and disease has only recently been appreciated. The rate of uptake (Jd) of a homologous series of saturated fatty alcohols into the jejunum is limited by diffusion through the UWL. The Jd of lauryl alcohol has been determined at different rates of stirring of the bulk phase, and at different sites along the intestine, in animals of different ages, in varying species, in rats with streptozotocin-induced diabetes mellitus, following abdominal irradiation, after acute and chronic exposure to ethanol, and after the feeding of various diets. The UWL varies in response to most of these experimental manipulations. After correcting for unstirred layer effects, the incremental change in free energy (integral of delta Fw----l) of the uptake of medium chain-length fatty acids and the maximal transport rate (Jmd) and Michaelis constant (Km) for glucose uptake were determined. These kinetic parameters changed in many of these experimental manipulations. However, there was no correlation between changes in UWL, integral of delta Fw----l, Jmd, Km or Jmd/Km. It is concluded that (1) the intestine is capable of adapting to a variety of physiological and pathological challenges; and (2) the major kinetic changes included UWL, integral of delta Fw----l, Jmd, and Km. The molecular mechanisms responsible for these changes in the dimensions and characteristics of the barriers to intestinal transport must now be defined.

Adaptation, Physiological↗

PubMed1984

Effect of chronic ingestion of ethanol on in vitro uptake of lipids and glucose in the rabbit jejunum.

This study was undertaken to determine the effect of chronic feeding of ethanol on the in vitro jejunal uptake of lipids and glucose. The first group of rabbits was fed ad libitum (CAL); the food intake of a second control group [weight control (WC)] was restricted to match their gain in body weight with that of a chronically ethanol-fed group (ETH); and the food intake of a third control group [food control (FC)] was restricted to match the food intake with that of ETH. There was a marked decline in cholesterol uptake in WC and FC compared with CAL, and cholesterol uptake in ETH was intermediate between the higher value in CAL and the lower value in WC and FC. The uptake of fatty acids 4:0-12:0 was similar in the CAL, FC, WC, and ETH groups, both when the bulk phase was stirred and unstirred; the uptake of fatty acids 16:0 and 18:0 was lower in WC and FC than in CAL; and the uptake of fatty acids 14:0, 16:0, and 18:0 was even lower in ETH. The uptake of a homologous series of fatty alcohols was greater in WC and ETH than in CAL at five different rates of stirring of the bulk phase. When the uptake of fatty acids 6:0-12:0 was corrected for unstirred layer resistance, a linear relation was noted between fatty acid chain length and the natural logarithm of rate of uptake/aqueous diffusion coefficient, and the steeper slope in WC and ETH than in CAL represented a higher incremental change in free energy. Glucose uptake was similar in CAL, WC, and FC but was greater in ETH from 5 to 40 mM glucose. These studies demonstrate that 1) weight restriction, food restriction, and chronic ethanol feeding are associated with a change in the effective resistance of the unstirred layer and in the passive permeability properties of the rabbit jejunum, and 2) ethanol has a differential effect on passive permeation of short-, medium-, and long-chain fatty acids and cholesterol.

Alcoholism↗

PubMed1984

Insulin and islet cell transplant--effect on intestinal uptake of lipids.

A previously validated in vitro technique was used to determine the effect of once-daily injections of NPH insulin (NPH) and islet cell transplant (ICT) on the enhanced uptake (Jd) of lipids into the intestine of diabetic rats. Three months after ICT, the urine volume, urine glucose, and fasting blood sugars were near normal. The Jd of lauryl alcohol was used to measure the effective resistance of the unstirred water layer (UWL); NPH was associated with an increase in UWL in the jejunum when the bulk phase was stirred or unstirred and a rise in UWL in the ileum when the bulk phase was unstirred but had no effect on UWL in the colon. The Jd of a homologous series of saturated medium-chain-length fatty acids in untreated diabetic rats was reduced with NPH and ICT. The Jd of cholesterol was lower in diabetic rats treated with NPH or ICT than in untreated diabetic rats over a wide range of concentrations of cholesterol, bile acid, and bile acid/cholesterol. The colon was less permeable than the jejunum to fatty acids or fatty alcohols. In contrast to the small intestine, diabetes had no effect on colonic uptake of these probes. Thus, injection of exogenous insulin or endogenous insulin supplied by ICT in diabetic rats reduced the Jd of lipids, normalized the effective resistance of the UWL, and reduced the enhanced passive permeability of the jejunum observed in diabetic animals.

Animals↗

PubMed1984

Asymmetry of canine tracheal epithelium: osmotically induced changes.

The symmetry of osmotic conductivity of the canine tracheal epithelial cells was examined in vitro. When an osmotic load of 100 mosM sucrose was added to the serosal bathing solution, no change in the transepithelial potential difference was observed in 15 tissue preparations. In contrast, when the same osmotic load was added to the mucosal bathing solution, there was a rapid decrease in the transepithelial potential difference of 3.9 +/- 0.5 mV (n = 23); ouabain (10(-4) M) eliminated this change. Tissues that had been exposed to the osmotic load added to either the mucosal or serosal side were compared with the control using light and electron microscopy. When the osmotic load was added to the mucosal fluid, there was no change in the nuclear-to-cytoplasmic area ratio of the cell types examined. However, when the same osmotic load was added to the serosal fluid, a marked increase in the nuclear-to-cytoplasmic area ratio of the ciliated cells was observed. This finding indicated cell shrinkage. Dilution potentials measured by substituting NaCl with mannitol also showed asymmetry. The morphological features are probably caused by differences in the osmotic conductivity (Lp) of the basolateral and apical cell membranes, with the Lp of the apical membrane being less than that of the basolateral membrane. The basis for osmotically induced potentials remained undetermined.

Animals↗

PubMed1984

Ranitidine versus cimetidine in the management of acute upper gastrointestinal tract bleeding.

Ranitidine and cimetidine were compared with respect to their effect on preventing the continuation or recurrence of acute upper gastrointestinal bleeding secondary to peptic ulcer disease. Fifty patients were randomly allocated to treatment with either ranitidine or with cimetidine. The two groups were comparable for age, sex, and severity of hemorrhage. There was no statistically significant difference in outcome between the groups when assessing need for surgery, total number of units in blood required, days in hospital, incidence of rebleeding, or deaths. However, there was a trend in favor of ranitidine: only one ranitidine-treated patient went to operation versus four of the cimetidine group. In addition, the number of rebleeds was higher in the cimetidine group (14) compared to the ranitidine group (1). Two patients in each group died. Therefore, ranitidine appears to be comparable to cimetidine in the management of patients with acute upper gastrointestinal tract bleeding. However, this study did not include a placebo group, and thus the generalized use of H2-receptor blockers in all patients with acute upper gastrointestinal tract bleeding has not been proven.

Acute Disease↗

PubMed1984

Comparative effects of two cimetidine regimens on 24-hour intragastric acidity in patients with asymptomatic duodenal ulcer.

The effect of 600 mg of cimetidine given twice daily on 24-hour intragastric hydrogen ion (H+) concentration was compared with that of the standard regimen of 300 mg of cimetidine given four times daily in six patients with asymptomatic duodenal ulcer. According to the double-blind, Latin-square, repeated-measures design, all subjects followed each cimetidine regimen and a placebo regimen for one week. Acid secretion studies and determinations of drug and gastrin levels in the blood were carried out on the last day of each treatment week. Although 600 mg of cimetidine BID suppressed H+ after breakfast and during the night, compared with placebo treatment (P less than 0.01), the 300-mg QID regimen suppressed H+ only after breakfast and supper (P less than 0.05). A higher percentage of pH readings greater than or equal to 3.0 were obtained with 600 mg of cimetidine BID than with 300 mg of cimetidine QID during the night (P less than 0.05); compared with percentages when placebo was taken, the percentages of pH readings greater than or equal to 3.0 were greater both overnight and during a 24-hour period only when 600 mg of cimetidine was given BID (P less than 0.01). The observed difference in intragastric H+ suppression after each regimen could not be explained by variations in serum concentrations of cimetidine or serum concentrations of gastrin. Despite similar peaks of serum cimetidine after evening doses of 300 or 600 mg of cimetidine, nocturnal intragastric acidity was lower in subjects given 600 mg BID. Further, H+ levels after lunch were similar in both cimetidine-treated groups, despite markedly higher serum cimetidine concentrations in patients receiving 600 mg BID. Pharmacokinetic studies showed equivalent elimination half-times and 24-hour areas under the curve of serum cimetidine concentration in patients on the two cimetidine regimens. Postprandial integrated gastrin responses were of similar magnitude in patients on either cimetidine regimen. There was no significant difference in mean serum gastrin concentrations during the night in placebo-treated and cimetidine-treated patients. Only a weak correlation was observed between H+ and serum gastrin concentration. Although a fluctuation of the H+:gastrin ratio occurred after each meal in all groups, the ratio was suppressed by both dosages of cimetidine. The findings suggest that a regimen of 600 mg of cimetidine BID is superior to the standard regimen of 300 mg QID in suppressing intragastric acidity in patients with asymptomatic duodenal ulcer.

Adult↗

PubMed1984

Effect of combination of antacid and cimetidine on 24-hour intragastric acidity in patients with asymptomatic duodenal ulcer.

UNLABELLED: By means of a Latin square design, the effect of antacid alone and in combination with cimetidine on a 24-hour intragastric hydrogen ion (H+) activity and serum gastrin profiles was studied in eight patients with duodenal ulcer. Antacid given seven times a day (one and three hours after meals and at bedtime) combined with 600 mg BID of cimetidine (C + A7) achieved greater suppression of H+ after breakfast, overnight, and over the 24-hour period than did antacid alone seven times daily (A7). Antacid given four times a day (one and three hours after lunch and after supper) combined with cimetidine BID (C + A4) maintained the neutralizing capacity during this time, but was less effective than the C + A7 regimen. However, C + A4 produced more suppression of nocturnal H+ than did A7. A higher percentage of the readings at or above pH 4.0 were obtained with C + A7 than with A7 or C + A4. A greater postprandial integrated gastrin response was obtained with all active treatments as compared with a placebo regimen. The mean peak cimetidine concentration (Cmax) was higher but the time to peak (Tmax) was shorter after the morning than after the evening dose. The area under the cimetidine concentration-time curve and the Cmax and Tmax values after the morning and evening doses of cimetidine were not affected by the coadministration of antacid. IN CONCLUSION: (1) combination therapy of cimetidine plus antacid is more effective than antacid alone in the reduction of intragastric H+; (2) antacid alone fails to suppress the overnight intragastric acidity; and (3) antacid given concurrently with cimetidine does not interfere with pharmacokinetic determinants of plasma cimetidine concentration.

Adult↗

PubMed1984

Comparative effects of pirenzepine and cimetidine, alone and in combination, on 24-hour gastric acidity in duodenal ulcer disease.

Both pirenzepine and cimetidine have been shown to be beneficial in the healing of duodenal ulcers. The aim of the present study was to determine the effects of 50 mg of pirenzepine BID and 600 mg of cimetidine BID, either alone or in combination, on 24-hour intragastric acidity, nocturnal gastric secretory volume and acid output, and serum gastrin profile in patients with duodenal ulcers. Eight asymptomatic patients with healed duodenal ulcers received placebo, pirenzepine, cimetidine, or cimetidine plus pirenzepine for one week each in a sequential order. All measurements were performed over a 24-hour period on the last day of each treatment week. Compared with pirenzepine, cimetidine was associated with lower hydrogen ion (H+) activities after breakfast, during the night, and over the 24-hour period. Pirenzepine alone failed to suppress H+, but the combination of cimetidine plus pirenzepine resulted in more prolonged acid suppression, with lower H+ after lunch, than did cimetidine alone. The effect of cimetidine on the suppression of nocturnal acid secretory volume and acid output was further enhanced by the addition of pirenzepine. The fasting serum gastrin concentrations were similar in all treatments, excluding one patient with antral G-cell hyperplasia; the postprandial gastrin responses were similarly higher with cimetidine and cimetidine plus pirenzepine than with pirenzepine. The findings suggest an added benefit of combination therapy with cimetidine and pirenzepine that may be useful in patients who fail to respond to single-agent therapy.

Adult↗

PubMed1984

Protein-energy intake and malnutrition in Crohn's disease.

A detailed nutrient assessment was made of 23 male and 24 female patients with Crohn's disease who entered sequentially into an outpatient clinic. Assessment included 48-hour dietary recall, anthropometric measurements, and biochemical and hematological tests appropriate to characterize protein-energy malnutrition. Approximately 40% of patients had energy intakes equal to only two-thirds of the Recommended Dietary Allowance (RDA). Three men and five women had relative body weights less than 85% of standard, but body weight was not correlated with energy intake. Relative body weight was correlated with arm muscle circumference in both male and female patients and with triceps skinfold and total lymphocyte count in women. Although the mean protein intake was greater than 150% of the RDA, evidence of protein malnutrition included low arm muscle circumference in 14% of the men and 15% of the women, low serum albumin concentration in 13% of the women, and low total lymphocyte count in one-half of the patients. The Crohn's disease activity index was correlated significantly with serum albumin, energy intake, and duration of disease in men and with serum ferritin and hemoglobin concentration in women. Thus, a reduced relative body weight or reduced serum albumin was not uncommon in patients with Crohn's disease but did not necessarily occur in those with reduced intakes of protein and energy. However, a low relative body weight may indicate need for further nutritional assessment.

Adolescent↗

PubMed1984

Cheilitis antedating Crohn's disease: case report and literature update of oral lesions.

Oral lesions occur in an impressive number of patients with Crohn's disease. The lesions often precede the intestinal symptoms, and follow a variable course from asymptomatic to severe. They are important because of their association with Crohn's disease and the possibility that they could lead to an earlier diagnosis of Crohn's disease. We present a patient with cheilitis which preceded the recognition of colonic and perianal Crohn's disease by 7 years. The cheilitis responded to injection of steroids into the lips, but was unaffected by oral prednisone, sulfasalazine, azathioprine, and metronidazole.

Adult↗