Overview
Protein, fats, and carbohydrates (macronutrients) normally are absorbed in the small intestine; the small bowel also absorbs about 80% of the eight to ten liters of fluid ingested daily. There are many different conditions that affect fluid and nutrient absorption by the intestine. A fault in the digestive process may result from failure of the body to produce the enzymes needed to digest certain foods.
Congenital structural defects or diseases of the pancreas, gall bladder, or liver may alter the digestive process. Inflammation, infection, injury, or surgical removal of portions of the intestine may also result in absorption problems; reduced length or surface area of intestine available for fluid and nutrient absorption can result in malabsorption.
Radiation therapy may injure the mucosal lining of the intestine, resulting in diarrhea that may not become evident until several years later. The use of some antibiotics can also affect the bacteria that normally live in the intestine and affect intestinal function.
Causes and symptoms
Protein, fats, and carbohydrates (macronutrients) normally are absorbed in the small intestine; the small bowel also absorbs about 80% of the eight to ten liters of fluid ingested daily. There are many different conditions that affect fluid and nutrient absorption by the intestine. A fault in the digestive process may result from failure of the body to produce the enzymes needed to digest certain foods.
Congenital structural defects or diseases of the pancreas, gall bladder, or liver may alter the digestive process. Inflammation, infection, injury, or surgical removal of portions of the intestine may also result in absorption problems; reduced length or surface area of intestine available for fluid and nutrient absorption can result in malabsorption. Radiation therapy may injure the mucosal lining of the intestine, resulting in diarrhea that may not become evident until several years later. The use of some antibiotics can also affect the bacteria that normally live in the intestine and affect intestinal function.
Diagnosing Malabsorption
Various tests are available to diagnose malabsorption : -
- Stool examination : - People suffering from malabsorption often have high fat content in their stools. Also, stools provide evidence of undigested food.
- Absorption tests : - Blood tests measuring various levels of nutrients are taken to determine whether absorption is taking place. In general, various levels of specific substances such as glucose in the blood increase after eating if proper digestion and absorption occur.
- X-rays : - X-rays of the intestine may be taken to determine whether the intestine is damaged, or if blockages are present that may inhibit absorption.
- Biopsy : - A biopsy of the intestine may be taken to determine whether the intestine is damaged, or whether bacteria are causing the problem.
Risk factors
Risk factors for malabsorption syndrome include : -
- premature birth
- family history of malabsorption or cystic fibrosis
- use of certain drugs, such as mineral oil or other laxatives
- travel to foreign countries
- intestinal surgery, including bowel transplantation
- excess alcohol consumption.
The most common symptoms of malabsorption include : -
- Anemia, with weakness and fatigue due to inadequate absorption of vitamin B12, iron, and folic acid
- Diarrhea, steatorrhea (excessive amount of fat in the stool), and abdominal distention with cramps, bloating, and gas due to impaired water and carbohydrate absorption, and irritation from unabsorbed fatty acids. The individual may also report explosive diarrhea with greasy, foul-smelling stools.
- Edema (fluid retention in the body's tissues) due to decreased protein absorption
- Malnutrition and weight loss due to decreased fat, carbohydrate, and protein absorption. Weight may be 80-90% of usual weight despite increased oral intake of nutrients.
- Muscle cramping due to decreased vitamin D, calcium, and potassium levels
- Muscle wasting and atrophy due to decreased protein absorption and metabolism
- Perianal skin burning, itching, or soreness due to frequent loose stools.
- Irregular heart rhythms may also result from inadequate levels of potassium and other electrolytes. Blood clotting disorders may occur due to a vitamin K deficiency. Children with malabsorption syndrome often exhibit a failure to grow and thrive.
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