Folic acid clinical presentation

The healthy small intestine contains only a small bacterial population, unlike the colon. However, an acute infection of the mucosa by a virus, bacterium or other parasite can reduce its motility, allowing a huge proliferation of the resident bacteria. Absorption of both macro- and micronutrients is impaired, resulting in the disorder known as sprue. Folic acid is particularly poorly absorbed, causing reduced rates of repair of mucosal cells. Hence, the damage persists and worsens to create a vicious circle. Treatment involves administration of an antibiotic to kill the bacteria and folic acid to allow damaged tissue to recover. The clinical presentation includes bulky stools, steatorrhoea (fatty faeces) and weight loss. 

Some findings of this clinical trial are that daily administration of folic acid, vitamin Bg and vitamin B12 to patients with recent stroke or transient ischemic attack was safe but did not seem to be more effective than placebo in reducing the incidence of major vascular events. These results do not support the use of B vitamins to prevent recurrent stroke. The results of ongoing trials and an individual patient data meta-analysis will add statistical power and precision to present estimates of the effect of B vitamins (VITATOPS Trial Study Group 2010). 

Following the introduction of the sulphonamides in clinical use, the antibacterial activity was found to be inhibited by the presence of pus. This inhibitory effect of pus was found to be due to the presence of the stmcturally similar p-aminobenzoic acid (PABA) a compound which is also present in folic acid. This led to the observation that the sulphonamides competed with PABA, leading to the dismption of folate synthesis and cessation of bacterial growth. The importance of the sulphonamides in... 

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