Bowel inadequate

Since there is no true excretion of iron from the body, iron-deficiency anemia occurs mostly because of inadequate absorption of iron or excess blood loss. Inadequate absorption may occur in patients who have congenital or acquired intestinal diseases, such as inflammatory bowel disease, celiac disease, or bowel resection. Achlorhydria and diets poor in iron also may contribute to poor absorption of iron. In contrast, iron deficiency also may occur in patients who exhibit a higher rate of iron loss from the body. This is manifested in... 

Not all calcium present in the diet is absorbed by the small intestine and mechanisms are present to ensure only amounts appropriate to body needs are absorbed. These processes are complex and involve the interaction of special transport protein, vitamin D and parathormone. Thus, abnormalities of calcium metabolism may result from many different disease processes. Diseases affecting the bowel may prevent normal absorption, diseases of the parathyroid gland may result in inappropriate levels of parathormone for calcium requirement and a nutritionally inadequate diet may cause vitamin D deficiency with consequent disordered calcium absorption. 

Deficiency conditions Pernicious anemia, deficiency caused by inadequate diet or intestinal malabsorption, hemolytic anemia, hyperthyroidism, bowel and pancreatic malignancies, gastrectomy, GI lesions, neurologic damage, malabsorption syndrome, metabolic disorders, renal disease... 

Diet Inadequate Ca " intake produces rickets or osteomalacia hypophosphatemia rarely (if ever) results from dietary inadequacy excess dietary Ca causes hypercalciuria and risk of urolithiasis. Ca " and inorganic phosphate are absorbed in the small bowel by active l,25-(OH)2D-requiring processes Ca " " decreases PTH secretion and may decrease loc-hydroxylase activity inorganic phosphate decreases la-hydroxylase activity. 

If oral absorption is impaired, part 2 of the test is conducted 5 to 7 days later. The second stage of the Schilling test differentiates inadequate secretion of intrinsic factor by the stomach from an abnormality in absorption by the ileum. Radiolabeled vitamin B12 is administered orally with a sufficient amount of intrinsic factor. Results within the normal range indicate that the defect is in the production of intrinsic factor as opposed to other causes of vitamin B12 deficiency such as dietary deficiency or small bowel pathology. Generally, abnormal results for stage 1 followed by a normal result in stage 2 is consistent with pernicious anemia. 

Among the disorders that result in inadequate absorption of vitamin Kfrom the GI tract are cystic fibrosis, sprue, inflammatory bowel disease, dysentery, and extensive bowel resection. Since drugs that greatly reduce the bacterial population of the bowel are used frequently in these disorders, the availability of the vitamin may be jurther reduced. Moreover, dietary restrictions also may limit the availability of the vitamin. For immediate correction of the deficiency, parenteral therapy should be used. 

As in meconium ileus, there is a motility disturbance of the bowel. However, it can also be related to absorption problems if inadequate feeding formula is used (so-called milk curd syndrome) (Devos and Meradji 2003). Clinical symptoms are similar to meconium plug syndrome or meconium ileus and are those of obstruction, such as progressive vomiting, progressive abdominal distension and failure to pass stools. Sometimes a mass can be felt in the (right) side of the abdomen. 

The major limitation of conventional trans-abdominal ultrasound (US) in evaluating the gastrointestinal tract is that it is difficult to achieve a detailed evaluation of the bowel wall structure and its changes due to the presence of air. In fact, luminal gas, in many instances, causes inadequate ultrasonographic imaging of the stomach, small intestine and, particularly, colon. 

Due to the ability of multidetector CT scanners to scan large volumes at faster speed with the ability to perform reconstruction following the examination, CT enteroclysis has become a more feasible extension of the conventional enteroclysis and CT methods of examining the small intestine. Using this technique, adequate luminal distention is mandatory because poorly distended loops can simulate disease or hide pathologic processes (Bender et al. 1999). In the past, inadequate small bowel luminal distention has necessitated nasojejunal intubation to infuse contrast material (Gore et al. 1996). 

Although superflcial mucosal lesions are easily missed due to inadequate spatial resolution, MR imaging is able to detect early inflammatory changes of the bowel wall, based on enhancement following intravenous injection of contrast medium. 

Perforation, stent migration and inadequate bowel decompression are the major procedure-... 

The inadequate intake of riboflavin seems to be the main cause for the deficiency of this vitamin, being common in populations whose diet lack dairy products and meat, and in anorexic individuals. Digestion and intestinal absorption disorders are other causes of disability, as observed in individuals with lactose intolerance, tropical sprue, coeliac disease and intestinal resection, as well as gastrointestinal and biliary obstruction. Other disorders such as diarrhoea, infectious enteritis and irritable bowel syndrome can cause poor absorption by increasing intestinal motility. Riboflavin deficiency also occurs in conditions such as chronic alcoholism, diabetes mellitus and inflammatory bowel diseases. 

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