Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First St. SW, Rochester, MN, USA.
Best Pract Res Clin Gastroenterol. 2012 Oct;26(5):663-75. doi: 10.1016/j.bpg.2012.11.003.
There is an undeniable link between gastrointestinal disorders and malnutrition. Chronic diarrhoea is one of the most common gastrointestinal conditions that can impact a patient's nutritional status. The nutritional consequences will depend on the cause of the diarrhoea as well as the location and extent of gastrointestinal involvement. In general, malabsorption plays a central role in the interaction between malnutrition and chronic diarrhoea. Malabsorption can result in both nutritional deficits and diarrhoea. With severe malnutrition, chronic diarrhoea can persist due to impaired immune function and poor mucosal recovery. Food intolerance and an inappropriate diet in the setting of malabsorption may also contribute to chronic diarrhoea. Patients may attribute their gastrointestinal symptoms to specific dietary intake, which can lead to self-imposed indiscriminate dietary restrictions. Therefore, disease-specific treatment in conjunction with appropriate nutritional counselling and intervention is recommended in the prevention and treatment of malnutrition in patients with chronic diarrhoea. Specialized nutritional support through enteral or parenteral administration may be required to treat severe caloric and micronutrient deficiencies. In this review, we aim to summarize the mechanism, diagnosis, and treatment of the nutritional consequences of chronic diarrhoea.
胃肠道疾病与营养不良之间存在着不可否认的联系。慢性腹泻是最常见的胃肠道疾病之一,会影响患者的营养状况。营养后果将取决于腹泻的原因以及胃肠道受累的部位和程度。一般来说,吸收不良在营养不良和慢性腹泻之间的相互作用中起着核心作用。吸收不良可导致营养缺乏和腹泻。在严重营养不良的情况下,由于免疫功能受损和黏膜恢复不良,慢性腹泻可能持续存在。在吸收不良的情况下,食物不耐受和不适当的饮食也可能导致慢性腹泻。患者可能将其胃肠道症状归因于特定的饮食摄入,这可能导致他们自行进行无差别的饮食限制。因此,建议在慢性腹泻患者的营养不良的预防和治疗中采用针对特定疾病的治疗方法,并结合适当的营养咨询和干预。可能需要通过肠内或肠外途径专门提供营养支持来治疗严重的热量和微量营养素缺乏。在这篇综述中,我们旨在总结慢性腹泻的营养后果的发生机制、诊断和治疗。