Intestinal Malabsorption In Folate-Deficient Alcoholics

Malnutrition with folate deficiency is frequently found among alcoholics, and could be caused in part by decreased intestinal absorption. To evaluate the relationship of nutrition and absorption in alcoholics, intestinal absorption was studied in patient volunteers placed on a folate-deficient diet with ethanol. Intestinal absorption was measured by conventional means and by the technique of triple lumen perfusion of the jejunum. In 2 patients who ingested ethanol, 200 g per day with a low folate diet, the dietary induction of folate deficiency was followed by decreased absorption of d-xylose, labeled folic acid (³H-pteroylglutamic acid), glucose, fluid, and sodium. Mild net secretion of fluid and sodium into the intestinal lumen was observed in a patient who remained sober on the low folate diet and in a patient who ingested ethanol, 300 g per day, with a regular diet. The morphology of the jejunal mucosa was not affected. These preliminary data suggest that the combination of dietary folate deficiency and prolonged ethanol intake results in intestinal malabsorption of several water-soluble substances, which may account in part for the poor nutrition often found in binge drinkers.