Description: Segment 1 Tomkins speaks to camera and describes how common malnutrition can be in patients with severe gastrointestinal disease. He begins by looking at a table which lists the physiological changes that occur during malnutrition, then a further table listing the kinds of intestinal disease that might lead to nutritional disorders he separates these into three types: protein-energy malnutrition, anaemia and electrolyte / trace element deficiencies. He begins with protein-energy malnutrition and describes how whole body protein should best be measured. Time start: 00:00:00:00 Time end: 00:06:39:00 Length: 00:06:39:00 Segment 2 To show how malnutrition in intestinal disease affects growth, Tomkins shows graphs detailing the physiological development of a young man with Crohn's disease his malnutrition meant that he had hardly grown between the ages of 11 and 17. Tomkins goes on to show how a patient might develop malnutrition. He shows an illustration detailing normal food absorption levels and then explains the various reasons that these levels may not be met in a person with an intestinal disease. He emphasises the importance of a trained dietician in helping to control the malnutrition. Time start: 00:06:39:00 Time end: 00:12:22:00 Length: 00:05:43:00 Segment 3 Tomkins shows a graph comparing amino acid and nitrogen absorption in normal and ill patients. He returns to the case discussed earlier of the young man with Crohn's diesase - in addition to his malnutrition due to lack of intestinal absorption, he was also not given enough calories to help his body fight off the fever and infection he suffered following surgery. He describes other ways in which the body, when unwell, needs more calories than normal in order to avoid malnutrition. Time start: 00:12:22:00 Time end: 00:18:08:00 Length: 00:05:46:00 Segment 4 Tomkins shows a graph detailing levels of protein loss from abnormal excretions which occur during intestinal disease - much larger quantities than normal of protein are found in faecal samples. Tomkins goes on to discuss a patient with stagnant loop syndrome. He describes the diagnosis of the condition, and focuses particularly on the high levels of albumin secretion in the patient, leading to malnutrition. Time start: 00:18:08:00 Time end: 00:22:43:00 Length: 00:04:35:00