Environmental Enteropathy: Pathogenesis
Environmental enteropathy is malabsorption disorder that occurs among residents or travelers of environments with poor sanitation and hygiene, for example tropical countries. Chronic exposure to fecal pathogens causes inflammation and structural changes in the small bowel, which ultimately result in malabsorption.
The development of environmental enteropathy is multifactorial, and predominantly associated with chronic exposure to contaminated food and water. It is more prevalent in environments where open defecation and lack of sanitation are common for example in tropical areas of Asia and South India.
The exposure to contaminated food and water leads to a generalized state of intestinal inflammation, the intestine is flooded with chronic inflammatory cells like lymphocytes, phagocytes and inflammatory cytokines.
The intestinal bacterial overgrowth and Enterocyte injury causes increase in plasma enteroglucagon which results on retardation of small-intestinal transit. Enteroglucagon causes intestinal stasis.
This continuous inflammatory response leads to mucosal injury, flattened villi and crypt hyperplasia. These changes result in poor absorption of food, vitamins and minerals. Malabsorption leads to malnutrition and stunted growth in children. In adults it causes weight loss, weakness and extreme fatigue.
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Revision for today https://creativemeddoses.com/topics-list/dysphagia-difficult-swallowing/
Further reading https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3372657/
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