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Malabsorption(Malabsorption Syndrome)

Pronounced: Mal-ab-sorp-shun

Definition

Malabsorption is when the body has trouble absorbing certain vitamins, minerals, carbohydrates, proteins, or fats from food even when someone is eating properly.

The Intestines


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Causes

During normal digestion, the liver creates a fluid called bile that helps break down food in the intestines. The pancreas also creates an enzyme that helps break food down into usable nutrients. The freed nutrients can then pass through the walls of the intestine and into the bloodstream. Malabsorption may be caused by a problem with any of these digestive steps such as:

  • Inflammation and irritation of the intestines can makes it difficult for the intestines to properly absorb nutrients. Inflammation may be caused by a number of conditions such as:
  • Decrease or loss of digestive fluids and enzymes because of:
    • Pancreas dysfunction which may occur with cystic fibrosis, pancreatitis, or pancreatic cancer
    • Liver injury or illness that can decrease bile production
    • Bacterial overgrowth syndrome
  • Improper breakdown of food in stomach or quick dumping from stomach
  • Surgical removal of part of the intestine (short bowel syndrome) or stomach—less surface area and time to absorb nutrients
  • Abnormal movement of bowel muscles which can be caused by systemic conditions like hypo/hyperthyroidism and diabetes
Risk Factors

Factors that may increase your chance of malabsorption include:

  • Medical conditions affecting the intestine, such as celiac disease, cystic fibrosis, or Crohn's disease
  • Use of laxatives
  • Excessive use of antibiotics
  • Intestinal surgery
  • Alcohol use disorder
  • Travel to countries with high incidence of intestinal parasites
Symptoms

Malabsorption may cause:

  • Weight loss
  • Abdominal distention and bloating
  • Diarrhea
  • Flatulence
  • Bulky, foul-smelling stools
  • Weakness and fatigue
  • Swelling or fluid retention
  • Muscle weakness
Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.

Your bodily fluids, waste products, and tissues may be tested. This can be done with:

  • Blood tests
  • Stool tests
  • Urine tests
  • Hydrogen breath test
  • Small bowel biopsy

Images may be taken of your bodily structures. This can be done with x-rays.

Your pancreas may be tested. This can be done with a pancreatic function test.

Treatment

In some people, the specific underlying condition must be treated in order to reverse the malabsorption. Other conditions cannot always be treated such as cystic fibrosis, short bowel, or pancreatic insufficiency.

Depending on the cause and severity of the malabsorption, you may need to make up for nutritional deficiencies by consuming additional nutrients through foods or supplements. A diet rich in vitamins and minerals along with increased quantities of fat, protein, or carbohydrate may be required. Nutrient supplementation may include folate, iron, and vitamin B12. In some cases, nutrients may be given by IV.

Prevention

Conditions that cause malabsorption need to be recognized and managed. Work with your doctor and follow the recommended treatment plan to decrease malabsorption complications.

RESOURCES:

American College of Gastroenterology
http://gi.org

National Organization for Rare Disorders
http://www.rarediseases.org

CANADIAN RESOURCES:

Health Link BC
http://www.healthlinkbc.ca

Health Canada
http://www.hc-sc.gc.ca

References:

Abdullah M, Firmansyah MA. Clinical approach and management of chronic diarrhea. Acta Med Indones. 2013;45(2):157-165.

Bacterial overgrowth syndrome. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/gastrointestinal_disorders/malabsorption_syndromes/bacterial_overgrowth_syndrome.html. Updated May 2016. Accessed January 20, 2017.

Chronic diarrhea. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114891/Chronic-diarrhea. Updated July 1, 2016. Accessed January 20, 2017.

Diarrheal diseases—acute and chronic. American College of Gastroenterology website. Available at: http://patients.gi.org/topics/diarrhea-acute-and-chronic. Updated December 2012. Accessed January 20, 2017.

Overview of malabsorption. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/gastrointestinal_disorders/malabsorption_syndromes/overview_of_malabsorption.html. Updated May 2016. Accessed January 20, 2017.



Last reviewed June 2016 by Daus Mahnke, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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