RESUMO
La gastroenteropatía pierde proteínas (PLE) es un síndrome que consiste en una pérdida activa proteica por el aparato digestivo y relacionada con enfermedades. Tras revisión amplia de la literatura (MEDLINE - PubMed),hemos encontrado escasas referencias de esta gastroenteropatía como causante de hipoalbuminemia asociada a desnutrición. Ello nos ha motivado para revisar la entidad y su diagnóstico, detallando algunos casos clínicos recientes de nuestra experiencia (AU)
Protein-losing gastroenteropathy (PLE) consists on anactive digestive tract protein loss syndrome and it is related to some diseases. After a wide research into bibliography (MEDLINE - Pubmed),we have found few references to this gastroenteropathy as a cause of hypoalbuminemia related to malnutrition. This has motivated us to review this entity, detailing some recent clinical cases of our experience (AU)
Assuntos
Humanos , Enteropatias Perdedoras de Proteínas/fisiopatologia , Hipoalbuminemia/fisiopatologia , Desnutrição/fisiopatologia , Fatores de Risco , alfa 1-Antitripsina/isolamento & purificaçãoRESUMO
Protein-losing gastroenteropathy (PLE) consists on an active digestive tract protein loss syndrome and it is related to some diseases. After a wide research into bibliography (MEDLINE - Pubmed),we have found few references to this gastroenteropathy as a cause of hypoalbuminemia related to malnutrition. This has motivated us to review this entity, detailing some recent clinical cases of our experience.
Assuntos
Gastroenteropatias/complicações , Gastroenteropatias/terapia , Hipoalbuminemia/etiologia , Hipoalbuminemia/terapia , Proteínas/metabolismo , Adulto , Idoso de 80 Anos ou mais , Azatioprina/uso terapêutico , Diarreia/etiologia , Suplementos Nutricionais , Diuréticos/uso terapêutico , Nutrição Enteral , Feminino , Gastroenteropatias/diagnóstico , Humanos , Hipoalbuminemia/diagnóstico , Hipoproteinemia/etiologia , Masculino , Albumina Sérica/análise , Albumina Sérica/metabolismo , Tuberculose Pulmonar/complicações , alfa 1-Antitripsina/metabolismoRESUMO
La mayoría de los casos de pancreatitis aguda se presentan como formas leves, en las que no se recomienda el soporte nutricional, a no ser que los pacientes no puedan reanudar su alimentación oral normal después de 5-7 días. Por el contrario, la pancreatitis grave cursa con estrés metabólico, y precisa de soporte nutricional precoz. En estos casos, se recomienda nutrición enteral, que debe complementarse con nutrición parenteral si es preciso. Estudios recientes indican que la nutrición enteral puede mejorar la evolución de la pancreatitis aguda grave, reducir las complicaciones y favorecer una recuperación más rápida de la enfermedad. La mayoría de los pacientes toleran una nutrición enteral oligomérica administrada en infusión continua distalmente al ángulo de Treitz. Estudios recientes apuntan, sin embargo, que la perfusión intragástrica es segura y puede ser una buena opción terapéutica en determinados pacientes con pancreatitis aguda grave. Además, agentes específicos añadidos a la nutrición (inmunomoduladores y probióticos) parecen reducir la estancia hospitalaria y las complicaciones infecciosas y no infecciosas de la pancreatitis aguda
Most of acute pancreatitis cases present as mild cases for which nutritional support is not recommended provided the patient is able to restart normal oral intake within 5- days. By contrast, severe pancreatitis associates metabolic stress and requires early nutritional support. In these cases, enteral nutrition is recommended, which should be supplemented with parenteral nutrition if needed. Recent studies indicate that enteral nutrition may improve the course of severe acute pancreatitis, reduce its complications and promote a quicker improvement from the disease. Most of the patients tolerate oligomeric nutrition administered as continuous infusion distally to the Treitz s angle. Recent studies show, however, that intragastric perfusion is safe and may be an adequate therapeutic option in particular patients with acute severe pancreatitis. Besides, specific agents added to the nutrition (immunomodulators and probiotics) seem to reduce hospital stay and infectious and non-infectious complications of acute pancreatitis
Assuntos
Humanos , Apoio Nutricional/métodos , Pancreatite/terapia , Doença Aguda , Pancreatite/dietoterapia , Pancreatite/metabolismo , ProbióticosRESUMO
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Assuntos
Humanos , Hospitais Públicos/normas , Terapia Nutricional , EspanhaRESUMO
Most of acute pancreatitis cases present as mild cases for which nutritional support is not recommended provided the patient is able to restart normal oral intake within 5- days. By contrast, severe pancreatitis associates metabolic stress and requires early nutritional support. In these cases, enteral nutrition is recommended, which should be supplemented with parenteral nutrition if needed. Recent studies indicate that enteral nutrition may improve the course of severe acute pancreatitis, reduce its complications and promote a quicker improvement from the disease. Most of the patients tolerate oligomeric nutrition administered as continuous infusion distally to the Treitz' s angle. Recent studies show, however, that intragastric perfusion is safe and may be an adequate therapeutic option in particular patients with acute severe pancreatitis. Besides, specific agents added to the nutrition (immunomodulators and probiotics) seem to reduce hospital stay and infectious and non-infectious complications of acute pancreatitis.
