Essential fatty acid sufficiency does not preclude fat-soluble-vitamin deficiency in short-bowel syndrome
Article Abstract:
Removal of sections of the small intestine may be a necessary treatment for inflammatory bowel disease, trauma, cancer, or other dysfunction. This can result in short-bowel syndrome, which is characterized by malabsorption, nutrient deficiencies, and other problems. Although parenteral (intravenous) feeding is sometimes needed, most patients eventually are able to return to normal oral feeding as the intestines adapt. One problem often encountered is the ability to absorb fatty nutrients such as fat-soluble vitamins (A, D, E, and K) and essential fatty acids (EFAs, fat components which must be available from diet as they cannot be made by human tissues) from food. It is usually assumed that proven absorption of fat-soluble vitamins demonstrates absorption of fats in general. A case is described of a 44-year-old man whose ability to absorb these vitamins was not equivalent to his ability to absorb EFAs. The patient had undergone removal of most of his small and large intestines to treat lymphoma, and had subsequently existed on total parenteral nutrition. After infection developed, the patient decided to return to oral feeding, and his ability to absorb fats was evaluated. After 11 months of oral feeding, no EFA deficiency (EFAD) was indicated by either blood tests or medical condition. However, blood levels of carotene, a vitamin A precursor, were not detectable, in spite of supplementation. Blood levels of vitamin E and vitamin A were normal, probably because of supplies available from tissue. Tests of clotting ability were abnormal, suggesting a deficiency of vitamin K or other clotting factor, and this was remedied by vitamin K injections. The study indicates that poor fat-soluble vitamin absorption does not necessarily prove poor EFA absorption, nor does adequate EFA absorption prove that fat-soluble vitamins are adequately absorbed. Absorption of each nutrient should be determined separately in patients with short-bowel syndrome. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Clinical Nutrition
Subject: Health
ISSN: 0002-9165
Year: 1991
User Contributions:
Comment about this article or add new information about this topic:
Plasma vitamin E and beta-carotene concentrations during radiochemotherapy preceding bone marrow transplantation
Article Abstract:
Patients with leukemia and aplastic anemia are typically treated with high-dose chemotherapy and total body irradiation followed by bone marrow transplantation (BMT). While it is designed to kill cancer cells, this combined regimen can be severely toxic to various healthy body tissues including the gastrointestinal tract, liver, lungs, and bladder. One possible way in which healthy cells are damaged is by a process called lipid peroxidation, in which the structure of fat molecules changes. Substances that function as anti-oxidants protect against peroxidation; two natural anti-oxidants are vitamin E and beta-carotene, a form of vitamin A. In nineteen patients, blood levels of vitamin E and beta-carotene were measured before, during and after BMT. After conditioning therapy (chemotherapy and radiation) used to prepare for BMT, these anti-oxidants were much lower in the blood, low enough to be considered critically deficient. Loss of these anti-oxidants may be a reason for organ toxicity occurring shortly after BMT. While patients received both vitamin E and beta-carotene in their intravenous feeding (total parenteral nutrition), the amounts provided were clearly not sufficient to counteract the peroxidation occurring during conditioning therapy. More research is recommended to assess whether high doses of vitamin E and beta-carotene can combat the toxic side effects of intensive cancer chemotherapy. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Clinical Nutrition
Subject: Health
ISSN: 0002-9165
Year: 1990
User Contributions:
Comment about this article or add new information about this topic:
Antioxidant nutrients and disease prevention: an overview
Article Abstract:
Oxygen-derived free radicals (unstable atoms containing unpaired electrons) are produced during certain biochemical reactions, for example the reduction of oxygen to hydrogen peroxide, and can damage DNA, proteins and cell membranes. Antioxidant nutrients such as selenium, zinc, copper, manganese, beta-carotene, and vitamins A, C and E may help protect cells from damage caused by free radicals. A deficiency of selenium has been associated with the development of a heart disease (Keshan disease) and a bone disease (Kachin Beck disease) in the People's Republic of China. Both diseases can be prevented and treated with selenium. There is some as yet unconfirmed evidence that dietary deficiencies of vitamins E and C may be associated with an increased risk for the development of coronary heart disease and certain cancers. Beta-carotene may have a protective effect against lung cancer in smokers. The role of antioxidant nutrients in disease prevention provides an exciting area of research that may document new links between nutrition and disease. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Clinical Nutrition
Subject: Health
ISSN: 0002-9165
Year: 1991
User Contributions:
Comment about this article or add new information about this topic:
- Abstracts: Causes and consequences of blood pressure alterations in obstructive sleep apnea. National high blood pressure education program working group report on ambulatory blood pressure monitoring
- Abstracts: Changes in rectal sensitivity after hypnotherapy in patients with irritable bowel syndrome. Modulation of orocaecal transit time by hypnosis
- Abstracts: Dental implant reconstruction after endodontic failure: report of case. Missing a tooth? A single-tooth implant may be for you
- Abstracts: Maternal and fetal influences on blood pressure. Breast feeding and protection against neonatal sepsis in a high risk population
- Abstracts: The variability of transfusion practice in coronary artery bypass surgery. To treat the patient or to treat the surgeon