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Exudative enteropathy occurs when the balance between protein production and breakdown, which is essential for the body to function properly, is disrupted by loss of protein from the plasma into the gut. Then, the concentration of albumin - the main proteins of the blood serum - is lowered, and then troublesome disease symptoms appear. What are the symptoms of exudative enteropathy? What is the treatment?

Exudative enteropathy(protein losing enteropathy - PLE) is a disorder in which too much protein passes from the blood plasma into the intestine. Hence the other name of the disease -protein-loss enteropathy .

Properly within the day, protein is produced in the liver in such amounts that it is later lost (e.g. through the digestive tract). A balance between protein production and breakdown is essential for the body to function properly. However, in the course of exudative enteropathy, the liver does not produce a sufficient amount of protein, i.e. the amount that would not only meet the body's needs, but also compensate for the loss of protein that has penetrated the intestinal mucosa in excessive amounts. Then the concentration of albumin (the main serum proteins, produced in the liver) in the blood serum decreases and symptoms of the disease appear.

Exudative enteropathy (with protein loss) - causes

Cause of exudative enteropathy may be:

  • heart diseases (e.g. right ventricular failure, pericarditis, birth defects);
  • damage to the lymphatic system (e.g. as a result of sarcoidosis, radiotherapy and chemotherapy during the treatment of neoplastic diseases);

The risk of exudative enteropathy is high, especially in the course of lupus, celiac disease and Crohn's disease

  • liver diseases (e.g. cirrhosis, hepatic vein thrombosis);
  • congenital defects of the lymphatic system (e.g. intestinal lymphangiomas);
  • numerous diseases of the digestive system (including gastric and duodenal ulcers, Crohn's disease, ulcerative colitis, gastric cancer, parasitic diseases of the digestive system);
  • systemic diseases of connective tissue (e.g. systemic lupus erythematosus,rheumatoid arthritis);

Overuse of painkillers and anti-inflammatory drugs can also lead to exudative enteropathy.

Exudative enteropathy (with protein loss) - symptoms

  • swelling all over the body;
  • diarrhea - long-lasting and fatty (stools have a very unpleasant putrid smell and their surface is shiny. Besides, they are difficult to rinse);
  • weight loss;
  • stomach pains;
  • ascites, i.e. an accumulation of fluid in the abdominal cavity (fluid may also accumulate in the pleura and the pericardial sac);

In addition, there are symptoms of deficiency of fat-soluble vitamins - deficiency of vitamin A (e.g. dry skin, acne, dry eye syndrome) and vitamin D (e.g. pathological fractures, conjunctivitis, degeneration of the system bone marrow and dermatitis).

Exudative enteropathy (with protein loss) - diagnosis

Blood tests are performed. In the case of exudative enteropathy, the levels of total protein and albumin are low, and cholesterol levels are elevated.

Faecal examination (to determine the excretion of alpha1-antitrypsin - blood plasma protein) and ultrasound or computed tomography of the abdominal cavity are also helpful.

If the doctor has doubts about the diagnosis, he or she may order an endoscopic examination, during which a sample of the intestine will be taken for histopoathological examination. In the laboratory, the atrophy of intestinal villi, infiltration and swelling of the intestinal mucosa are observed.

Exudative enteropathy (with protein loss) - treatment

Treat the disease that led to the development of exudative enteropathy. When it is healed, the symptoms disappear. However, this does not apply to diseases such as, for example, systemic lupus erythematosus or Crohn's disease, as it is not possible to cure them completely. You can only alleviate their symptoms. In the case of such diseases, the patient should be under constant medical supervision.

In addition, the patient should supplement vitamins and minerals (to supplement their deficiency in the body). Dehydration drugs are also administered periodically, and by the intravenous route, albumin (proteins) and blood plasma are administered.

If the symptoms of the disease are severe, partial parenteral nutrition is used.

Exudative enteropathy (with protein loss) - important diet

An important element in the treatment of enteropathy is a proper diet - especially high-protein diet. The patient should receive 1.5 to 3.0 grams of protein per kilogram of body weight per day. After that, you should limit s alt and fats (specifically long-chain fatty acids).

You should use preparations with medium-chain fatty acids at the same time, as they lead to the reduction of malabsorption.

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