Malabsorption in Overland Travellers to India

Tomkins, Andrew; James, W. P. T.; Walters, John; Cole, A. C. E.

doi:10.1136/bmj.3.5927.380

Cited by 33 publications

(9 citation statements)

References 17 publications

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“…Patients with large bowel disease were excluded. The clinical features of our patients were similar to those described previously (Tomkins, James, Walters & Cole, 1974). Fourteen of the patients were Europeans who had developed symptoms while resident or travelling in India, the Far East or Central America.…”

Section: Patientssupporting

confidence: 52%

Assessment of Early and Delayed Responses in Vitamin B12 Absorption during Antibiotic Therapy in Tropical Malabsorption

1978

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1. Vitamin B12 absorption was measured in 18 patients with tropical malabsorption. 2. Absorption was particularly impaired in patients with severe mucosal lesions. 3. Sequential measurements with 57Co- and 58Co-labelled vitamin B12 were made before and 48 h after the start of tetracycline therapy. A rapid improvement (on average 22% increase in absorption) occurred in four of six patients with marked mucosal lesions. Further improvement occurred in four of five patients measured after 4 weeks' tetracycline, including the two who failed to improve initially. 4. These rapid changes in vitamin B12 absorption after antibiotics occur too early to be due to mucosal recovery and suggest that bacterial metabolism is an important factor in the malabsorption in these patients.

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Section: Patientssupporting

confidence: 52%

Assessment of Early and Delayed Responses in Vitamin B12 Absorption during Antibiotic Therapy in Tropical Malabsorption

1978

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“…These groups have been described in detail elsewhere (Tomkins et al, 1974;Tomkins et al, 1975). Student's t test was used for statistical comparison of results.…”

mentioning

confidence: 99%

Giardiasis: clinical and therapeutic aspects.

Wright¹,

Tomkins²,

Ridley³

1977

Gut

122

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SUMMARY Malabsorption was present in 29 of 40 symptomatic patients with giardiasis. Twentythree had impaired D-xylose absorption; in 20 vitamin B12 absorption was low, and 15 patients had steatorrhoea. More severe malabsorption was associated with more marked histological abnormalities. Metronidazole, 2-0 g as a single daily dose on three successive days, produced a parasitological cure rate of 91%. In contrast, the standard course of mepacrine, 100 mg thrice daily for 10 days, eradicated the parasite in only 63% of patients. Improvements in absorption and jejunal morphology followed anti-giardial treatment. Tetracycline in eight patients failed to eradicate the parasite, intestinal absorption was unaltered, and histological appearances of the jejunal mucosa often deteriorated.

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“…The illness in these children showed some features similar to the postinfective illness seen in adults returning from the tropics (Tomkins et al, 1974), in particular there was a severe enteropathy and low folate levels. In Case 1, Klebsiella was isolated from the duodenal juice and this organism may play a role in the pathophysiology of protracted diarrhoea in such adult patients (Klipstein et al, 1973).…”

Section: Discussionmentioning

confidence: 58%

Acute inflammatory bowel disease in childbood: a new disease?

Manuel¹,

Kilby²,

Candy³

et al. 1978

Archives of Disease in Childhood

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SUMMARY Three children aged between 7 and 11 years, after an acute onset of diarrhoea and vomiting, developed protracted diarrhoea and severe loss of weight. None had been abroad. No significant aetiological agent was found. There was evidence of acute inflammatory disease on proximal small intestinal biopsy, and some evidence of more widespread gut involvementof the rectum in Cases 1 and 2, and the terminal ileum in Cases 2 and 3. The disease resolved spontaneously and without relapse.Acute diarrhoea and vomiting in the developed world is usually a self-limiting illness of short duration in children beyond infancy. This report concerns 3 older children in whom illness started with the acute onset of diarrhoea and vomiting that did not resolve as expected, and in whom evidence of acute inflammation was found in both the small and large intestine. Its purpose is to draw attention to this disease and to describe the spontaneous resolution which occurred despite the severe and prolonged nature of the illness. Case reportsCase 1. A 6-year-old boy was admitted with a 3-week history of diarrhoea, vomiting, and a weight loss of 5 kg. He had no abdominal pain, had not travelled abroad, or been in contact with diarrhoeal illness. Lomotil was the only drug administered before admission to hospital.On examination he was 5% dehydrated with a distended, non-tender abdomen. His height was on the 90th centile, his weight, at 21 kg, had fallen from the 97th to the 25th centile. Haemoglobin (Hb), white blood count (WBC), erythrocyte sedimentation rate (ESR), immunoglobulins, C14 glycocholate breath test, urinary indican, normal. Serum iron 7 -5 ,±mol/l (41-9 ,ug/100 ml) range 13 6-28-2 (76-0-157 5 ,tg/100 ml), total iron binding capacity (TIBC) 47 4 F±mol/l (265,ug/l00 ml) range 44-6-69 -3 (249-387 ,ug/100 ml), saturation 15 9% range

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Malabsorption in Overland Travellers to India

Cited by 33 publications

References 17 publications

Assessment of Early and Delayed Responses in Vitamin B12 Absorption during Antibiotic Therapy in Tropical Malabsorption

Assessment of Early and Delayed Responses in Vitamin B12 Absorption during Antibiotic Therapy in Tropical Malabsorption

Giardiasis: clinical and therapeutic aspects.

Acute inflammatory bowel disease in childbood: a new disease?

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