Malabsorption

Malabsorption means the inability to absorb nutrients from food. This is usually associated with a gastrointestinal disorder or systemic disease. Long-term malabsorption can lead to anemia, stones (kidney and gallbladder), osteoporosis, osteopenia, vitamin deficiencies, malnutrition, etc.

Causes and risk factors

Common causes and risk factors associated with malabsorption are:

Infectious diseases or conditions:

  • Whipple's disease
  • Intestinal tuberculosis
  • Bacterial overgrowth
  • Giardia lamblia
  • Fish tape worm (B12 malabsorption)
  • Roundworm
  • Hookworm
  • AIDS and HIV

Post surgery anatomy change:

  • Blind loops
  • Gastrectomy
  • Bypass surgery
  • Short bowel syndrome

Gastrointestinal disorders:

  • Crohn's Disease
  • Eosinophilic gastroenteropathy
  • Celiac disease
  • Amyloidosis
  • Cystic fibrosis
  • Chronic pancreatitis
  • Carcinoma of pancreas
  • Biliary atresia
  • Primary bile acid diarrhea
  • Zollinger-Ellison syndrome
  • Milk intolerance
  • Fructose intolerance
  • Lactose intolerance
  • Sucrose intolerance
  • Abeta-lipoproteinaemia

Systemic diseases:

  • Hypothyroidism
  • Hyperthyroidism
  • Addison's disease
  • Diabetes mellitus
  • Hyperparathyroidism
  • Hypoparathyroidism
  • Systemic sclerosis
  • Carcinoid syndrome

Medications:

  • Cholestyramine
  • Tetracycline
  • PPI
  • Colchicine
  • Laxatives

Others:

  • Radiation enteritis

Symptoms and signs:

  • Diarrhea
  • Fatty stools (steatorrhea)
  • Weight loss
  • Fatigue
  • Weakness
  • Bloating
  • Failure to thrive
  • Malnutrition
  • Growth retardation

Diagnosis and Treatment

Diagnosis of malobsorption is usually based on symptoms, patient's underlying medical problems, risk factors, clinical suspicion, and one or more of the following tests:

  • Blood works
  • Stool studies
  • X-ray
  • CT scan
  • Endoscopy

After malabsorption is confirmed, treatment will focus on the underlying cause and management of complications. A nutritionist or dietitian may help to balance your nutrition.

References:

  1. PubMed Health.
  2. Wikipedia.
  3. Mayo clinic online health information.
  4. Sleisenger and Fordtran's Gastrointestinal and Liver Disease- by Mark Feldman MD, et al.
  5. The Little Black Book of Gastroenterology-by David W. Hay.
  6. Principles of Clinical Gastroenterology by Tadataka Yamada, et al.


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