Malabsorption Syndrome
Definition
Is a collection of symptoms caused by the inability of the digestive system to absorb one or more of the major vitamins (especially Vitamin B12), minerals (iron, calcium) and nuttrients (carbohydrates, fats & proteins)
Causes & Pathophysiology
Most common : Diseases of the small intestine
Mucosal disorders (transport), Infectious diseases, bile acid deficiency, Zollinger-Ellison syndrome, pancreatic insufficiency, resection of intestinal parts, disaccharidase deficiency, lactose intolerance etc cause a defective absorption and assimilation of various nutrients.
The deficiency of various nutrients lead to respective symptoms due to impaired metabolism.
Clinical Manifestations
Diarrhoea - freuent, loose, bulky, foul-smelling stools with increased fat content and greyish color.
Abdominal distention
Pain
Increased flatus
Weakness
Weight loss
Malaise
Easy bruising
Osteoporosis
Anemia
Vitamin deficiencies
Emaciation
Dehydration
Lab Studies
Stool studies - quantitative and qualitative fat anlysis, lactose tolerance tests, D-xylose absorption tests and Schilling tests
The hydrogen breath test to evaluate carbohydrate absorption
Endoscopy and biopsy of the mucosa
USGM
CT Scan
X-Rays
CBC
Pancreatic function test
Medical Management
Avoid dietary substances that aggravate malabsorption
Supplements of vitamins, minerals
Reduce gluten in celiac sprue
Folic acid for tropical sprue
Antibiotics (e.g. tetracycline, ampicillin) if needed
Antidiarrhoeal agents (loperamide)
Parenteral fluids if dehydration +
Nursing Management
Patient and family educated about the facts of the diagnosis, and dietary management
Monitor fluid and electrolyte status
To look for osteoporosis
