Malignancy, weight loss, and the small intestinal mucosa

Abstract

The mucosal architecture and mucosal dynamics of the small bowel were studied in patients with malignant disease not of the gastrointestinal tract, but associated with severe weight loss. Mucosal changes in malignant disease are demonstrated by stereomicroscopy, mucosal architectural measurement, and decreased lactose utilization. Measurement of the epithelial DNA loss rate indicates, in association with mucosal measurement, that the architectural changes are caused by a hypoplasia of the epithelium. Similar findings are demonstrated in patients with profound weight loss due to other non malignant wasting diseases. Mucosal changes occur in malignant disease, but the concept of 'cancer enteropathy' is not tenable. It is suggested that mucosal changes are the effect of, and not the cause of, cachexia.