Malabsorption studies in cirrhosis of the liver

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Abstract
The incidence and the cause of malabsorption were studied in 20 patients with Laennec''s cirrhosis. The presence or absence of steatorrhea was evaluated by fecal fat studies, of pancreatic insufficiency by pancreozymin-secretin test, of small bowel disease by D-xylose excretion test, roentgenogram of the small intestine, and peroral jejunal mucosal biopsies. Chemical steatorrhea was found in 10 of the 20 cirrhotic patients. There was no evidence of primary absorptive defect of the small intestine, as revealed by D-xylose tolerance test, Ba meal, and mucosal biopsy studies. An abnormal pancreozymin-secretin test was observed in 15 of the 20 patients. Each of the 10 patients with chemical steatorrhea had an abnormal pancreozymin-secretin test. Replacement with pancreatic extracts produced marked improvement in the fecal fat excretion. These findings suggest that pancreatic dysfunction might be the primary cause of malabsorption in these 10 patients with Laennec''s cirrhosis. All of the patients studied were alcoholics, a population in which pancreatic dysfunction is rather common. The interrelationship of cirrhosis and pancreatitis was not investigated; both cirrhosis and pancreatitis are independently linked to the same cause, namely alcoholism.