Two patients are described whose clinical condition deteriorated following gastric surgery for peptic ulceration. Both were demonstrated to be suffering from gluten enteropathy with generalized malabsorption which included lactose.
Following treatment with a gluten-free diet over a 2-year period the jejunal mucosa showed a marked improvement of villous architecture associated with a return of lactose absorption to normal in one patient. This supports the view that following a gastro-jejunal anastomosis the gastric secretion is not itself injurious to the jejunal mucosal structure.
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