Adaptive hyperphagia in patients with postsurgical malabsorption

Gastroenterology. 1990 Dec;99(6):1814-9. doi: 10.1016/0016-5085(90)90492-j.


The specific nutritional consequences of malabsorption after small-bowel surgery were studied in a consecutive series of 48 ambulatory patients who had had small-bowel resection (n = 43) or bypass (n = 5) and in 10 patients who had an ileal pouch (n = 10). The patients received a 3-day standardized oral regimen providing daily 30 kcal/kg of ideal body weight (IBW). Throughout the study, 41 patients had malabsorption (fecal fat greater than 5%); 17 had fecal fat less than 5% and served as controls. The malabsorption patients absorbed 70% of protein and 71% of fat. Twenty-one were normonourished and 20 had features of mild energy malnutrition, vs. 15 and 2 controls, respectively. Compared with controls, malabsorption patients had decreased body weight and triceps skin-fold but no features of protein malnutrition. their mean daily food intake at home was significantly enhanced (39.6 +/- 13.1 kcal/IBW kg) vs. controls (28.8 +/- 5.8 kcal/IBW kg, P less than 0.001). In the malabsorption group, caloric intake was higher in the normonourished patients than in those with mild malnutrition. This study shows that a chronic malabsorption has limited nutritional consequences. The patients compensate for their absorptive handicap by increasing their oral intake.

MeSH terms

  • Absorption
  • Adaptation, Physiological*
  • Adolescent
  • Adult
  • Aged
  • Dietary Fats / pharmacokinetics
  • Dietary Proteins / pharmacokinetics
  • Eating
  • Energy Intake
  • Female
  • Humans
  • Hyperphagia / etiology*
  • Intestine, Small / surgery*
  • Malabsorption Syndromes / complications
  • Malabsorption Syndromes / etiology*
  • Malabsorption Syndromes / physiopathology
  • Male
  • Middle Aged
  • Nutritional Status
  • Postoperative Complications*
  • Prospective Studies


  • Dietary Fats
  • Dietary Proteins