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Oral Absorption Tolerance Tests in Tropical Sprue

Oral Absorption Tolerance Tests in Tropical Sprue Abstract Introduction After the introduction of liver extract by Castle and co-workers,1 adequate and striking clinical improvement has been observed in nearly all patients with tropical sprue in Puerto Rico. At the present time most patients receive folic acid therapy for control of anemia and gastrointestinal symptoms. The course and response to prolonged treatment has been described by Rodriguez-Molina.2 His follow-up study of patients treated for 10 years emphasized that a complete remission of the process is not possible. Despite a satisfactory hematological remission, indiscretions in the daily diet with excess fatty, fried, starchy, or sweet foods would accentuate diarrhea. Only 25% of the patients had normal blood values.Past studies have indicated a megaloblastic macrocytic anemia, steatorrhea, impaired absorption of glucose, and abnormal x-ray patterns of the small bowel in untreated patients with tropical sprue.* The present study was initiated to evaluate the oral absorption of several foodstuffs References 1. References 3 and 4. 2. Dr. M. Paniagua and Dr. D. Santiago-Stevenson cooperated in referring patients for study. 3. Dr. Rafael Rodriguez-Molina aided in this work by allowing us to study some patients for these observations. 4. References 12 and 16. 5. References 14 and 15. 6. Castle, W. B.; Rhoads, C. P.; Lawson, H. A., and Payne, G. C.: Etiology and Treatment of Sprue: Observations on Patients in Puerto Rico and Subsequent Experiments on Animals , Arch. Int. Med. 56:627-699, 1935.Crossref 7. Rodriguez-Molina, R.: Sprue in Puerto Rico —10 Years Later , Puerto Rico J. Pub. Health 18:314-340, 1943. 8. Suarez, R. M.: Clinical and Hematological Review of Sprue Based on the Study of 150 Cases , Puerto Rico J. Pub. Health 14:157-175, 1938. 9. Asenjo, C. F.: Criteria for Assessing Fat Absorption in Normal Subjects and Sprue Patients , Am. J. Trop. Med. 1:344-354, 1952. 10. Adlersberg, D.; Marshak, R. H.; Colcher, H.; Drachman, S. R.; Friedman, A. I., and Wang, C. I.: The Roentgenologic Appearance of the Small Intestine in Sprue: Long-Term Studies with Special Reference to Differential Diagnosis , Gastroenterology 26:548-578, 1954. 11. Gardner, F. H.: A Malabsorption Syndrome in Military Personnel in Puerto Rico , A. M. A. Arch. Int. Med. 98:44-60, 1956.Crossref 12. Turner, D. A., and Brien, F. S.: The Measurement of Absorption from the Intestine and the Xylose Tolerance Test , Canad. J. M. Technol. 15: 41-45, 1953. 13. Mendeloff, A. I.: The Effects of Eating and of Sham Feeding upon the Absorption of Vitamin A Palmitate in Man , J. Clin. Invest. 33:1015-1021, 1954.Crossref 14. Consolazio, C. F.; Johnson, R. E., and Marek, E.: Metabolic Methods Clinical Procedures in the Study of Metabolic Functions , St. Louis, C. V. Mosby Company, 1951. 15. McCoord, A. B.: The Use of 1,2-Dichloreethane in the Carr-Price Antimony Trichloride Reagent for the Determination of Vitamin A , J. Lab. & Clin. Med. 42:660-662, 1953. 16. Frazer, A. C., and Stewart, H. C.: Ultramicroscopic Particles in Normal Human Blood , J. Physiol. 90:18-30, 1937. 17. Fourman, L. P. R.: The Absorption of Xylose in Steatorrhea , Clin. Sc. 6:289-294, 1948. 18. Brien, F. S.; Turner, D. A.; Watson, E. M., and Geddes, J. H.: A Study of Carbohydrate and Fat Absorption from the Normal and Diseased Intestine in Man: I. Absorption and Excretion of d-Xylose , Gastroenterology 20:287-293, 1952. 19. Fourman, L. P. R.: Changes in Blood Phosphate After Ingestion of Glucose and Fructose in Sprue , Brit. M. J. 2:411-413, 1947. 20. Fourman, L. P. R., cited by Turner, D. A.: Absorption from the Intestine , Thesis, University Western Ontario Faculty of Medicine, 1950. 21. Hele, M. P.: The Phosphorylation and Absorption of Sugars in the Rat: 1. Hexokinase Activity in the Intestinal Mucosa , Biochem. J. 55: 857-863, 1953. 22. Legerton, C. W.; Texter, E. C., and Ruffin, J. M.: Observations on the Vitamin A Tolerance Curve as an Index of Fat Absorption , Gastroenterology 23:477-481, 1953. 23. Black, D. A. K., and Simpson, J. A.: Serum Lipides in Tropical Sprue , Tr. Roy. Soc. Trop. Med. & Hyg. 41:241-254, 1947. 24. Suarez, R. M.: Clinical and Hematological Review of Sprue Based on the Study of 150 Cases , Ann. Int. Med. 12:529-535, 1938. 25. Suarez, R.: Sprue, in Clinical Tropical Medicine , edited by R. B. H. Gradwohl, L. Benitez Soto, and O. Felsenfeld, St. Louis, C. V. Mosby Company, 1951, chap. 60 . 26. Nadel, H., and Gardner, F. H. Bacteriological Assay of Small Bowel Secretion in Tropical Sprue , J. Trop. Med. , to be published. 27. Gardner, F. H., and Romero, C.: A Preliminary Study of Small Bowel Mucoproteins in Tropical Sprue , Am. J. M. Sc. 231:82-85, 1956. 28. Gardner, F. H.: Observations on the Cytology of Gastric Epithelium in Tropical Sprue , J. Lab. & Clin. Med. 47:529-539, 1956. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives of Internal Medicine American Medical Association

Oral Absorption Tolerance Tests in Tropical Sprue

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Publisher
American Medical Association
Copyright
Copyright © 1956 American Medical Association. All Rights Reserved.
ISSN
0888-2479
DOI
10.1001/archinte.1956.00250280069009
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Abstract

Abstract Introduction After the introduction of liver extract by Castle and co-workers,1 adequate and striking clinical improvement has been observed in nearly all patients with tropical sprue in Puerto Rico. At the present time most patients receive folic acid therapy for control of anemia and gastrointestinal symptoms. The course and response to prolonged treatment has been described by Rodriguez-Molina.2 His follow-up study of patients treated for 10 years emphasized that a complete remission of the process is not possible. Despite a satisfactory hematological remission, indiscretions in the daily diet with excess fatty, fried, starchy, or sweet foods would accentuate diarrhea. Only 25% of the patients had normal blood values.Past studies have indicated a megaloblastic macrocytic anemia, steatorrhea, impaired absorption of glucose, and abnormal x-ray patterns of the small bowel in untreated patients with tropical sprue.* The present study was initiated to evaluate the oral absorption of several foodstuffs References 1. References 3 and 4. 2. Dr. M. Paniagua and Dr. D. Santiago-Stevenson cooperated in referring patients for study. 3. Dr. Rafael Rodriguez-Molina aided in this work by allowing us to study some patients for these observations. 4. References 12 and 16. 5. References 14 and 15. 6. Castle, W. B.; Rhoads, C. P.; Lawson, H. A., and Payne, G. C.: Etiology and Treatment of Sprue: Observations on Patients in Puerto Rico and Subsequent Experiments on Animals , Arch. Int. Med. 56:627-699, 1935.Crossref 7. Rodriguez-Molina, R.: Sprue in Puerto Rico —10 Years Later , Puerto Rico J. Pub. Health 18:314-340, 1943. 8. Suarez, R. M.: Clinical and Hematological Review of Sprue Based on the Study of 150 Cases , Puerto Rico J. Pub. Health 14:157-175, 1938. 9. Asenjo, C. F.: Criteria for Assessing Fat Absorption in Normal Subjects and Sprue Patients , Am. J. Trop. Med. 1:344-354, 1952. 10. Adlersberg, D.; Marshak, R. H.; Colcher, H.; Drachman, S. R.; Friedman, A. I., and Wang, C. I.: The Roentgenologic Appearance of the Small Intestine in Sprue: Long-Term Studies with Special Reference to Differential Diagnosis , Gastroenterology 26:548-578, 1954. 11. Gardner, F. H.: A Malabsorption Syndrome in Military Personnel in Puerto Rico , A. M. A. Arch. Int. Med. 98:44-60, 1956.Crossref 12. Turner, D. A., and Brien, F. S.: The Measurement of Absorption from the Intestine and the Xylose Tolerance Test , Canad. J. M. Technol. 15: 41-45, 1953. 13. Mendeloff, A. I.: The Effects of Eating and of Sham Feeding upon the Absorption of Vitamin A Palmitate in Man , J. Clin. Invest. 33:1015-1021, 1954.Crossref 14. Consolazio, C. F.; Johnson, R. E., and Marek, E.: Metabolic Methods Clinical Procedures in the Study of Metabolic Functions , St. Louis, C. V. Mosby Company, 1951. 15. McCoord, A. B.: The Use of 1,2-Dichloreethane in the Carr-Price Antimony Trichloride Reagent for the Determination of Vitamin A , J. Lab. & Clin. Med. 42:660-662, 1953. 16. Frazer, A. C., and Stewart, H. C.: Ultramicroscopic Particles in Normal Human Blood , J. Physiol. 90:18-30, 1937. 17. Fourman, L. P. R.: The Absorption of Xylose in Steatorrhea , Clin. Sc. 6:289-294, 1948. 18. Brien, F. S.; Turner, D. A.; Watson, E. M., and Geddes, J. H.: A Study of Carbohydrate and Fat Absorption from the Normal and Diseased Intestine in Man: I. Absorption and Excretion of d-Xylose , Gastroenterology 20:287-293, 1952. 19. Fourman, L. P. R.: Changes in Blood Phosphate After Ingestion of Glucose and Fructose in Sprue , Brit. M. J. 2:411-413, 1947. 20. Fourman, L. P. R., cited by Turner, D. A.: Absorption from the Intestine , Thesis, University Western Ontario Faculty of Medicine, 1950. 21. Hele, M. P.: The Phosphorylation and Absorption of Sugars in the Rat: 1. Hexokinase Activity in the Intestinal Mucosa , Biochem. J. 55: 857-863, 1953. 22. Legerton, C. W.; Texter, E. C., and Ruffin, J. M.: Observations on the Vitamin A Tolerance Curve as an Index of Fat Absorption , Gastroenterology 23:477-481, 1953. 23. Black, D. A. K., and Simpson, J. A.: Serum Lipides in Tropical Sprue , Tr. Roy. Soc. Trop. Med. & Hyg. 41:241-254, 1947. 24. Suarez, R. M.: Clinical and Hematological Review of Sprue Based on the Study of 150 Cases , Ann. Int. Med. 12:529-535, 1938. 25. Suarez, R.: Sprue, in Clinical Tropical Medicine , edited by R. B. H. Gradwohl, L. Benitez Soto, and O. Felsenfeld, St. Louis, C. V. Mosby Company, 1951, chap. 60 . 26. Nadel, H., and Gardner, F. H. Bacteriological Assay of Small Bowel Secretion in Tropical Sprue , J. Trop. Med. , to be published. 27. Gardner, F. H., and Romero, C.: A Preliminary Study of Small Bowel Mucoproteins in Tropical Sprue , Am. J. M. Sc. 231:82-85, 1956. 28. Gardner, F. H.: Observations on the Cytology of Gastric Epithelium in Tropical Sprue , J. Lab. & Clin. Med. 47:529-539, 1956.

Journal

A.M.A. Archives of Internal MedicineAmerican Medical Association

Published: Oct 1, 1956

References