Small intestine disorders

Divalproex sodium is comprised of sodium valproate and valproic acid. The delayed-release and extended-release formulations are converted in the small intestine into valproic add, which is the systemically absorbed form. It was developed as an antiepileptic drug, but also has efficacy for mood stabilization and migraine headaches. It is FDA-approved for the treatment of the manic phase of bipolar disorder. It is generally equal in efficacy to lithium and some other drugs for bipolar mania. It has particular utility in bipolar disorder patients with rapid cycling, mixed mood features, and substance abuse comorbidity. Although not FDA-approved for relapse prevention, studies support this use, and it is widely prescribed for maintenance therapy. Divalproex can be used as monotherapy or in combination with lithium or an antipsychotic drug.31... 

Intrinsic factor is produced by the parietal cells. Within the stomach, it combines with vitamin Bu to form a complex necessary for absorption of this vitamin in the ileum of the small intestine. Vitamin B12 is an essential factor in the formation of red blood cells. Individuals unable to produce intrinsic factor cannot absorb vitamin B12 and red blood cell production is impaired. This condition, referred to as Pernicious anemia, occurs as a result of an autoimmune disorder involving destruction of parietal cells. 

Krishnamurthy S, Schuffler MD Pathology of neuromuscular disorders of the small intestine and colon. Gastroenterology 1987 93 610-639. 

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. 

Regier DA, Narrow WE, Rae DS The epidemiology of anxiety disorders the Epidemiologic Catchment Area (ECA) experience. J Psychiatr Res 24 3-14, 1990 Rehfeld JF Immunochemical studies on cholecystokinin, II distribution and molecular heterogeneity in the central nervous system and small intestine of man and hog. J Biol Chem 253 4022-4030, 1978... 

The depressant effect of EOs on smooth muscle in the small intestine is consistent with the therapeutic uses of these aromatic plants as gastrointestinal anti-spasmodics and carminatives [224]. In vitro studies showed that EOs produced the inhibition of gastric motility, and are thus the basis of the treatment of some gastrointestinal disorders [225, 226]. 

When damp-heat accumulates in the Lower-Jiao, bland and cold or bitter and cold herbs that enter the Bladder and Small Intestine meridians and can leach out or dry damp-heat should be selected if there is a urinary disorder. Pungent and warm herbs that can stimulate the intestines and eliminate dampness should be used together with bitter and cold herbs that clear heat in the intestines when there is a disorder of bowel movement. 

Increase in TAC is not always a good prognostic it may simply indicate an initial response to oxidative stress, as with concentrations of individual antioxidants and activities of antioxidant enzymes, or when it is due to disturbances in uric acid metabolism. Because uric acid is the main determinant of TAC of blood plasma, TAC increases in situations when the concentration of urate is increased, for example, in metabolic disorders and kidney failure. TAC is increased in urine from renal transplant recipients with delayed graft function (SI6). Ischemia of small intestine leads to an increase in TAC of rat blood serum, which is maximal (almost twofold) immediately after termination of 45-min ischemia (S22). TAC of blood plasma of rats poisoned with a high dose of carbon tetrachloride (1200 mg/kg, intraperitoneal injection, measurement 16 hr after injection) was significantly (over twofold) increased (Kl). These apparently paradoxical effects can be explained, however, by release of antioxidants from cells undergoing necrosis. Increase in TAC after intensive physical exercise also may be a marker of tissue... 

Additionally, patients with familial adenomatous polyposis, an autosomal-dominant disease characterized by numerous small intestinal and colonic polyps with a nearly universal progression to colon cancer, have a favorable response to NSAIDs. Administration of NSAID (usually sulindac) to patients with this disorder reduces the number and size of polyps (DuBois et al., 1996). Recent biochemical evidence indicates that colon polyps and colon cancer are frequendy associated with induction of Cox-2 in the lesion as assessed by expression of Cox-2 mRNA and protein. Such induction appears to correlate with growth of the lesion, and inhibition of Cox-2 correlates with apoptosis of the involved cells (Gupta and DuBois, 1998). 

In medicine, bromelain is effective in die treatment of inflammation and edema is a wide variety of tissues [2,4-7,103.1081. to cure digestive disorders by means of replacement therapy [109], and in cardiovascular and circulatory disorders [95], and it may be important in protecting die small intestine from... 

In genetically susceptible individuals, ingestion of cereal prolamins from wheat, barley, rye, and possibly oats initiates an inflammatory disorder during which the small intestinal mucosa is damaged. This process is accompanied by malabsorption, activation of the intestinal immune system, and... 

A major indication for colon-specific drug delivery is in the treatment of local disorders of the colon, such as inflammatory bowel disease (IBD which includes ulcerative colitis and Crohn s disease) and carcinoma of the colon. The colon can also be used as an absorption site for the delivery of drags to the systemic circulation. Although absorption from the colon is generally considerably lower than from the small intestine, systemic drag delivery via the colon is associated with a number of advantages, including ... 

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. 

Hartnup disorder is an autosomal recessive impairment of neutral amino acid transport affecting the kidney tubules and small intestine. It is believed that the defect is in a specific system responsible for neutral amino acid transport across the brush-border membrane of renal and intestinal epithelium, but the defect has not yet been characterised. 

Hereditary fructose intolerance is an autosomal recessive disorder with reduced activity of aldolase B in the liver, kidney, and small intestine. Ingestion of only a few grams... 

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