Small Bowel in Hypoproteinemic States

Abstract

In order to study the effects of protein deficiency on functional and structural derangements of small intestine, 18 cases of primary malnutrition, 10 cases of cirrhosis of the liver, 17 cases of nephrotic syndrome and 20 normal control subjects were investigated.

Total serum proteins were less than 6 g% in all patients, or significantly lower than normal levels of 7.3 ± 0.4g%.

Clinical manifestations suggesting nutritional failure were present in all the patients with primary malnutrition. Patients with cirrhosis of the liver and nephrotic syndrome did not present features suggesting malabsorption.

In 4 patients with primary malnutrition and 2 patients with cirrhosis of the liver mild steatorrhea was found. Normal control subjects on a 100 g fat diet were found to excrete 3.7 ± 1.15 g of fecal fat per 24 hours. D-xylose test was found to be abnormal in 9 patients with primary malnutrition and in 6 patients with cirrhosis of the liver.

Jejunal biopsies were studied in 38 patients and in all the 20 normal control subjects. Mild to moderate mucosal abnormalities were found in about two-thirds of the patients with hypoproteinemia due to primary malnutrition (15 cases), cirrhosis of the liver (10 cases), and nephrotic syndrome (13 cases). Amongst the 20 normal subjects, 3 showed mild (grade 1) abnormality while in the others the mucosa was entirely normal.

Key-words:

• Intestine, small
• proteins
• nutrition
• jejunum
• biopsy
• intestinal absorption