Malabsorption associated with extreme malnutrition: importance of replacing plasma albumin.

An elderly man had severe malnutrition secondary to esophagogastric obstruction by carcinoma. Tube feeding resulted in diarrhea. Malabsorption ceased, and full enteral nutrition with elemental diet was tolerated immediately following albumin infusion. Clinical and experimental data indicate that this role for albumin, in enteral absorption, is related to its oncotic properties. Severe deficits can be reversed rapidly, simultaneously restoring the plasma concentration and GI function.