Problems with Intestinal Absorption

1
Problems with Intestinal Absorption
Intraluminal Maldigestion
Mucosal Malabsorption
Lymphatic Obstruction
impaired uptake and transport of available
intraluminal nutrients across the mucosal surface
interferes with transport of the products of fat
digestion to the systemic circulation
defect in processing of nutrients in intestinal
lumen
pancreatic insufficiency
neoplasm
celiac disease
hepatobiliary disease
trauma
Crohns disease
congenital
intraluminal bacterial growth
2
Marieb Fig. 23.33
3
Marieb Fig. 23.33
4
Marieb Fig. 23.33
5
Marieb Fig. 23.33
6
(No Transcript)
7
(No Transcript)
8
(No Transcript)
9
http//pediatric.um-surgery.org/clinical/physician
_content/a-m/meconium_ileus.shtml
10
Bariatric Surgery
11
Bariatric Surgery
Most often used
Restrictive Surgeries restrict total volume and
total food intake
Malabsorptive Surgeries (with or without
restriction)
Vertical Banded Gastroplasty (VBG)
Silicone Ring Vertical Banded Gastroplasty (SRG)
Adjustable Silicon Gastric Banding (ASGB)
If no modification of eating behaviors, may
experience significant postprandial vomiting
Said to not interfere with normal digestive
process
Chew food well and slow down eating pace
12
laparoscopic gastric banding (lap-band)
http//egh.org/healthcare_services/bariatric/weigh
t_loss_surgery/weight_loss_surgery_options/

• pouch initially holds about 1 oz of food and
  expands to 2 3 oz over time
• lower outlet usually has a diameter of only ¼

13
Bariatric Surgery
Restrictive Surgeries restrict total volume and
total food intake
Malabsorptive Surgeries (with or without
restriction)
Roux-en-Y Gastric Bypass (RYGB)
Jejunal-Ileal Bypass (JIB)
Bilio-Pancreatic Diversion (BPD)
Duodenal Switch (DS)
Reduces calorie AND nutrient absorption
14
(No Transcript)
15
most frequently performed weight loss surgery
in the United States
Roux-en-Y Gastric Bypass (RYGB) Involves
bypassing most of the stomach, except about 2oz),
the duodenum, and a variable length of the
proximal jejunum
May develop deficiencies of iron, B12, folate,
and calcium
16
(No Transcript)
17
heme gt Fe2 gt Fe3
? pH facilitates the bioavailability of iron
Figure 16-3
18

• Vitamin B12
• essential for the synthesis of DNA
• prevents abnormal FAs from being incorporated
  into neuronal lipids

Hallmark of vitamin B12 deficiency is
megaloblastic anemia
Figure 16-8