{"id":203,"date":"2017-12-24T18:19:50","date_gmt":"2017-12-24T18:19:50","guid":{"rendered":"http:\/\/clinicalbiochemistry.net\/?page_id=203"},"modified":"2019-01-01T10:40:37","modified_gmt":"2019-01-01T10:40:37","slug":"book-chapter-gastrointestinal-disorders-and-malabsorption","status":"publish","type":"page","link":"http:\/\/clinicalbiochemistry.net\/?page_id=203","title":{"rendered":"Book Chapter: Gastrointestinal Disorders and Malabsorption"},"content":{"rendered":"<p><strong>McDowell, G <\/strong>&amp; Brydon, G. (2016) \u2018<strong>Gastrointestinal Disorders and Malabsorption<\/strong>.\u2019 In: Admed, N. (ed) (2016)<em><strong> Fundamentals of Biomedical Science Clinical Biochemistry<\/strong><\/em>. 2nd Edition. Oxford University Press. pp 420-444. (25 pages)<\/p>\n<p><strong>Learning objectives<\/strong><\/p>\n<p>After studying this chapter you should be able to:<\/p>\n<ul>\n<li>Explain the different functions of acid in the stomach and bile acids in the small intestine<\/li>\n<li>Identify the secretion and absorption processes within the small intestine<\/li>\n<li>Explain the functions of secretin and cholecystokinin in nutrient digestion<\/li>\n<li>Describe the symptoms and laboratory diagnosis of gut hormone secreting tumours<\/li>\n<li>Discuss the advantages and limitations of the faecal elastase test as a measure of exocrine pancreatic disease<\/li>\n<li>Outline the use of simple tests for initial investigation of patients with chronic watery diarrhoea<\/li>\n<li>Discuss the biochemical tests used to investigate malabsorption<\/li>\n<li>Outline the factors which have contributed to some gastrointestinal tests becoming obsolete<\/li>\n<\/ul>\n<p><strong>Introduction<\/strong><\/p>\n<p><img data-attachment-id=\"158\" data-permalink=\"http:\/\/clinicalbiochemistry.net\/?attachment_id=158\" data-orig-file=\"https:\/\/i0.wp.com\/clinicalbiochemistry.net\/wp-content\/uploads\/2017\/12\/Clinical-Biochemistry-Book-pages-1-e1549719979164.png?fit=600%2C791\" data-orig-size=\"600,791\" data-comments-opened=\"0\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Clinical Biochemistry Book pages\" data-image-description=\"\" data-image-caption=\"\" data-medium-file=\"https:\/\/i0.wp.com\/clinicalbiochemistry.net\/wp-content\/uploads\/2017\/12\/Clinical-Biochemistry-Book-pages-1-e1549719979164.png?fit=227%2C300\" data-large-file=\"https:\/\/i0.wp.com\/clinicalbiochemistry.net\/wp-content\/uploads\/2017\/12\/Clinical-Biochemistry-Book-pages-1-e1549719979164.png?fit=750%2C990\" loading=\"lazy\" class=\"size-medium wp-image-158 alignleft\" src=\"https:\/\/i0.wp.com\/clinicalbiochemistry.net\/wp-content\/uploads\/2017\/12\/Clinical-Biochemistry-Book-pages-1.png?resize=227%2C300\" alt=\"\" width=\"227\" height=\"300\"  data-recalc-dims=\"1\">The use of biochemical tests for the diagnosis of gastrointestinal disease has increased over recent years, as a result of several analytical developments.<\/p>\n<p>Many older laboratory tests have become obsolete because of their poor predictive value and have been replaced by improved ones, which if used appropriately can facilitate or exclude a diagnosis. The advent of procedures such as <strong>endoscopy<\/strong>, where a flexible tube is passed through the mouth or the anus (<strong>colonoscopy<\/strong>) to visualize and sample tissues within the gastrointestinal tract, have transformed patient investigation. However, these are invasive, expensive procedures and some are not without risk.<\/p>\n<p>Laboratory diagnosis of <em>Helicobacter pylori<\/em>, the microorganism which is the major cause of duodenal and gastric <strong>ulcers<\/strong>, has significantly reduced the upper endoscopy workload. Serological testing for <strong>coeliac disease<\/strong>, caused by sensitivity to <strong>gluten<\/strong> in the diet, has resulted in more frequent investigation for this disease and has revealed a much higher incidence than previously thought.<\/p>\n<p>The importance of tests in faeces, the ultimate receptacle of gastrointestinal secretions, is now recognized. Some proteins released from fluids, sites of inflammation, or from bacteria, are stable in faeces and have significant diagnostic potential, providing direct information about gastrointestinal pathology. The introduction of specific commercial immunoassays to identify and quantify these proteins has greatly facilitated and standardized this process. In this chapter, you will be introduced to the basic biochemical and, where relevant, physiological processes in the gut, their optimization for digestion and absorption, and how diagnostic tests have evolved to investigate the breakdown of gut homeostasis.<\/p>\n\n<a class=\"maxbutton-6 maxbutton maxbutton-fundamentals-clinical-biochemistry-book\" title=\"Link to Publisher\" href=\"https:\/\/global.oup.com\/academic\/product\/clinical-biochemistry-9780199674442?lang=en&#038;cc=gb\"><span class='mb-text'>Link to Publisher<\/span><\/a>","protected":false},"excerpt":{"rendered":"<p>McDowell, G &amp; Brydon, G. (2016) \u2018Gastrointestinal Disorders and Malabsorption.\u2019 In: Admed, N. (ed) (2016) Fundamentals of Biomedical Science Clinical Biochemistry. 2nd Edition. Oxford University Press. pp 420-444. (25 pages) Learning objectives After studying this chapter you should be able<\/p>\n","protected":false},"author":1,"featured_media":157,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"jetpack_post_was_ever_published":false,"_links_to":"","_links_to_target":""},"jetpack_shortlink":"https:\/\/wp.me\/P9tPlw-3h","jetpack-related-posts":[{"id":191,"url":"http:\/\/clinicalbiochemistry.net\/?page_id=191","url_meta":{"origin":203,"position":0},"title":"Book Chapter: Abnormal Pituitary Function","date":"December 24, 2017","format":false,"excerpt":"McDowell, G. (2016) \u2018Abnormal Pituitary Function\u2019. In: Admed, N. (ed) (2016) Fundamentals of Biomedical Science Clinical Biochemistry. 2nd Edition Oxford University Press. pp 263-283. (21 pages) \u00a0 Learning objectives After studying this chapter you should be able to: Describe the basic structure and function of the endocrine system Explain the\u2026","rel":"","context":"Similar post","img":{"alt_text":"","src":"https:\/\/i0.wp.com\/clinicalbiochemistry.net\/wp-content\/uploads\/2017\/12\/Clinical-Biochemistry-Book-pages-227x300.png?resize=350%2C200","width":350,"height":200},"classes":[]},{"id":193,"url":"http:\/\/clinicalbiochemistry.net\/?page_id=193","url_meta":{"origin":203,"position":1},"title":"Book Chapter: Thyroid Function","date":"December 24, 2017","format":false,"excerpt":"McDowell, G. (2016) \u2018Thyroid Disease\u2019. In: Admed, N. (ed) (2016) Fundamentals of Biomedical Science Clinical Biochemistry. 2nd Edition. Oxford University Press. pp 284-299. (16 pages) \u00a0 Learning objectives After studying this chapter you should be able to: Describe the structure and function of the thyroid gland Explain the function of\u2026","rel":"","context":"Similar post","img":{"alt_text":"","src":"https:\/\/i0.wp.com\/clinicalbiochemistry.net\/wp-content\/uploads\/2017\/12\/Clinical-Biochemistry-Book-pages-1-227x300.png?resize=350%2C200","width":350,"height":200},"classes":[]},{"id":488,"url":"http:\/\/clinicalbiochemistry.net\/?page_id=488","url_meta":{"origin":203,"position":2},"title":"Book Chapter: Biophysical and molecular targets.","date":"January 1, 2019","format":false,"excerpt":"Slevin, M., Carroll, M., Murgatroyd, C. &\u00a0McDowell, G.(2014) \u2018Biophysical and molecular targets.\u2019 In: Kibos, A.S., Knight, B.P., Essebag, V., Fishberger, S.B., Slevin, M. & Tintoiu I. (eds.) (2014)\u00a0Cardiac Arrhythmias: From Basic Mechanisms to State-of-the-art Management. London: Springer pp. 335-343 (9 pages) Cardiac arrhythmias represent a large heterogeneous collection of heart\u2026","rel":"","context":"Similar post","img":{"alt_text":"","src":"https:\/\/i0.wp.com\/clinicalbiochemistry.net\/wp-content\/uploads\/2019\/01\/Cardiac-Arrhthmias-Book-Full-size-e1549719879589.png?fit=600%2C848&resize=350%2C200","width":350,"height":200},"classes":[]},{"id":196,"url":"http:\/\/clinicalbiochemistry.net\/?page_id=196","url_meta":{"origin":203,"position":3},"title":"Book Chapter: Point of Care Testing","date":"December 26, 2017","format":false,"excerpt":"Still, J., Petley, L. & McDowell, G. (2016) \u2018Point of Care Testing.\u2019 In: Admed, N. (ed) (2016) Fundamentals of Biomedical Science Biomedical Science Practice. 2nd\u00a0Edition. Oxford University Press. pp 377-399 (23 pages). \u00a0 Learning objectives After studying this chapter, you should be able to: Describe the basis and regulations that\u2026","rel":"","context":"Similar post","img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":218,"url":"http:\/\/clinicalbiochemistry.net\/?page_id=218","url_meta":{"origin":203,"position":4},"title":"Book Chapter: ELISA Development","date":"December 27, 2017","format":false,"excerpt":"McDowell, G., Body, R., Kirwan, C., Byrne, G. & Slevin, M. (2015) \u2018A Scheme for the Development and Validation of Enzyme Linked Immunosorbent Assays (ELISA) for Measurement of Angiogenic Biomarkers in Human Blood.\u2019 In: Slevin, M. & McDowell, G. (eds.) (2015) Handbook of Vascular Biology Techniques. London: Springer pp.453-463 (10\u2026","rel":"","context":"Similar post","img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":121,"url":"http:\/\/clinicalbiochemistry.net\/?page_id=121","url_meta":{"origin":203,"position":5},"title":"Research Papers","date":"December 22, 2017","format":false,"excerpt":"Body, R., McDowell, G., Carley, S., Ferguson, J. & Mackway-Jones, K. (2010) \u2018Diagnosing acute myocardial infarction with troponins: how low can you go?\u2019 Emerg Med J. 27 pp. 292-296. Body, R., Carley, S., Wibberley, C., McDowell, G., Ferguson, J. & Mackway- Jones, K. (2010) \u2018The value of symptoms and signs\u2026","rel":"","context":"Similar post","img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]}],"_links":{"self":[{"href":"http:\/\/clinicalbiochemistry.net\/index.php?rest_route=\/wp\/v2\/pages\/203"}],"collection":[{"href":"http:\/\/clinicalbiochemistry.net\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"http:\/\/clinicalbiochemistry.net\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"http:\/\/clinicalbiochemistry.net\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/clinicalbiochemistry.net\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=203"}],"version-history":[{"count":2,"href":"http:\/\/clinicalbiochemistry.net\/index.php?rest_route=\/wp\/v2\/pages\/203\/revisions"}],"predecessor-version":[{"id":495,"href":"http:\/\/clinicalbiochemistry.net\/index.php?rest_route=\/wp\/v2\/pages\/203\/revisions\/495"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/clinicalbiochemistry.net\/index.php?rest_route=\/wp\/v2\/media\/157"}],"wp:attachment":[{"href":"http:\/\/clinicalbiochemistry.net\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=203"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}