LACTASE DEFICIENCY IN ADULTS. A CAUSE OF "FUNCTIONAL" DIARRHOEA.
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Biomedical subjects
Publications and source records attributed to A M DAWSON.
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Anaemia due to pyridoxine deficiency has not previously been described in adult coeliac disease. The patient described here had a sideroblastic bone marrow showing the characteristic perinuclear rings of iron-containing granules and biochemical evidence of pyridoxine deficiency. These changes disappeared completely when the patient was put on a gluten-free diet.
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A technique is described for collecting thoracic duct lymph in a portable glass saddle from an unrestrained rat. Uniformly labelled oleic acid in various physical states was given to rats with thoracic duct and bile fistulae to study the influence of bile salts on the amount absorbed and on the route of transport and esterification after absorption. It is suggested that in addition to their emulsifying action bile salts may stimulate the esterification of absorbed oleic acid by the intestinal mucosa.
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The plasma free fatty acid level was raised in the majority of 131 patients with a variety of liver disorders, and included both those with severe liver cell damage and those with relatively good liver cell function and obstructive jaundice. This raised level is probably due to an increased mobilization of depot fat, for glucose, which inhibits peripheral liberation of free fatty acids, caused a fall in the plasma level and obliteration of the femoral venous-arterial difference in patients with liver disease comparable with that in normal persons. In addition, the plasma free fatty acid flux was measured using palmitate-1-C(14) and was found to be increased in patients with liver disease.
The validity of using water-soluble unabsorbable markers in the study of fat absorption was investigated. Nine subjects were fed a finely emulsified test meal containing carbohydrate, protein, fat, and the water-soluble unabsorbable markers, polyethylene glycol, and/or phenol red. The ratio of fat to marker in recovered gastric contents was significantly different from that in the test meal. This was due to the dissociation of the meal into two phases, a solid phase rich in fat and poor in marker and a liquid phase poor in fat and rich in marker. The liquid was preferentially emptied from the stomach and also more readily sampled by a small bore tube. When this artifact is disregarded samples obtained from the proximal small intestine would erroneously indicate an extensive and rapid absorption of fat in the duodenum and proximal jejunum.
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