Malabsorption means the failure of the GI tract, usually the small intestine, to absorb one or more substances from the diet. This is generally the result of some defect or damage to the mucosal lining of the small intestine where most of our nutrient absorption takes place. The most common symptoms of malabsorption syndrome are diarrhea, bloating, flatulence, cramping and weight loss. Over time, one may become deficient in iron, proteins, various vitamins and minerals and this can lead to degrees of malnutrition and a variety of anemias.
The most common anemias that may occur are vitamin B12, folate, and iron deficiency. Vitamin K malabsorption causes the blood to thin out and could result in excess bleeding. Protein depletion can lead to impaired bone formation and osteoporosis, and calcium deficiency leads to weakening and demineralization of the bone, causing a condition called osteomalacia. Impaired absorption of vitamin A could result in poor vision and night blindness as well as dermatitis. Malabsorption of protein, fat and carbohydrate leads to loss of calories, generalized malnutrition and diarrhea.
The small intestine which is just beyond the stomach, is the site of most of our absorption and a variety of conditions in that location can produce malabsorption syndrome. Celiac disease (sprue, gluten - sensitive enteropathy) is a condition where the mucosal lining of the small intestine is damaged by ingestion of gluten. Gluten is a protein found in wheat, rye, barley and oats but not in corn or rice. The mechanisms and reason for this reaction is unknown, but it is thought to be genetic in nature and likely an autoimmune condition and is not considered an allergy. Maintaining a gluten-free diet restores the damaged mucosal lining to normal and allows one to absorb normally leading to a normal life. On occasion patients may fail to respond to a gluten-free diet and could have refractory sprue or intestinal lymphoma. Prednisone (steroids) may be helpful in up to 50 percent of patients with refractory disease.
Crohn's disease is an inflammatory or ulcerating condition of the GI tract that may affect the small intestine thus resulting in malabsorption syndrome. If treated properly, absorption can be restored (for more information see Crohn's disease). Tropical sprue is a bacterial mediated disease causing a similar picture to that of celiac disease and should be suspected in anyone presenting with malabsorption that has visited the tropics. Treatment consists of antibiotics, often Tetracycline, for up to 6 months.
Whipples disease is a systemic bacterial illness usually affecting middle age men and presents diarrhea, arthritis, fever, weight loss, swollen lymph nodes and skin pigmentation. It is diagnosed by taking a small bowel biopsy through an endoscope, and the treatment is antibiotics for one year or longer.
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Other Gastrointestinal Diseases:
- Celiac Sprue |
Crohn's Disease |
Colon Cancer |
Colon Polyps |
Colorectal Cancer Screening Guidelines for 2001 |
Constipation |
Diarrhea |
Diverticulosis |
Esophageal Strictures |
Fecal Incontenence |
Gastrointestinal Bleeding |
GERD Treatment Guidelines Summary |
Helicobacter Pylori |
Hemorrhoids |
Irritable Bowel Syndrome |
Lactose Intolerance |
Malabsorption Syndromes |
Pancreatic Cancer |
Pancreatitis |
Pilonidal Cysts |
Puritis Ani |
Rectal Abscess |
Rectal Prolapse |
Treatment of Anal Fissures |
Ulcerative Colitis |
Whipple's Disease
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