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Alternative Names: Intestinal Malabsorption Syndrome.
This condition is a state of impaired absorption of nutrients in the small intestine. Specific causes -- of which there are many -- lead to different patterns in malabsorption, involving for example fat and fat-soluble vitamins (A, D, E and K), vitamin B12, folic acid, iron, protein or carbohydrates.
The main purpose of the Gastrointestinal tract is the digestion and absorption of major nutrients (fat, carbohydrate, and protein), essential micronutrients (vitamins and trace minerals), water, and electrolytes. Digestion involves both mechanical and enzymatic breakdown of food. Mechanical processes include chewing, gastric churning, and the to-and-fro mixing in the small intestine. The final products of digestion are absorbed through the intestinal epithelial cells. A defect in any one of these processes may produce a state of malabsorption.
Causes & Development
The many possible causes of malabsorption include:Diagnosis & Tests
Diarrhea is often present clinically, although this may not be the immediate cause for seeing a physician.
If suspected, a stool exam and other tests may be ordered by a doctor. The following findings suggest that intestinal malabsorption is occurring:- Increased number and size of fat globules in stool
- increased neutral fat (unsplit fats) indicates impaired fat digestion
- increased free fatty acids (split fats) indicates normal fat digestion but impaired fat absorption
- Increased quantity of fat in 72-hr stool sample after the patient has been on a 100-g fat diet daily for three days
- Decreased serum carotene indicates fat malabsorption or decreased dietary intake of carotene.
- Impaired D-xylose tolerance test (decreased urinary excretion of a measured amount of ingested xylose) indicates impaired jejunal mucosal absorption of xylose. Because this carbohydrate does not require digestion by pancreatic enzymes, the tolerance test is normal in pancreatic insufficiency and does not indicate maldigestion.
- Decreased serum levels of total protein, albumin, y-globulin, iron, folate, vitamin B12, calcium, phosphorous, magnesium, and cholesterol result from impaired intestinal absorption.
- Anemia - macrocytic, due to impaired absorption of folate or vitamin B12; microcytic, due to iron deficiency
- Increased urine oxalate accompanying steatorrhea indicates an increase in colonic absorption of oxalates and their excretion in urine.
- Prolonged prothrombin time results from impaired vitamin-K absorption.
- Intestinal biopsy may show mucosal villous atrophy, tumor, or inflammation.
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Recommendations and treatments for Intestinal Malabsorption Syndrome:
KEY | | Highly recommended |
GLOSSARY
Anemia (Anaemia, Anemias)
A condition resulting from an unusually low number of red blood cells or too little hemoglobin in the red blood cells. The most common type is iron-deficiency anemia in which the red blood cells are reduced in size and number, and hemoglobin levels are low. Clinical symptoms include shortness of breath, lethargy and heart palpitations.
Bacteria (Bacterial, Bacterium)
Microscopic germs. Some bacteria are "harmful" and can cause disease, while other "friendly" bacteria protect the body from harmful invading organisms.
Biopsy
Removal of a sample of tissue from a living being for diagnosis. A pathologist later uses a microscope to look for certain features, such as cancer cells, in the sample. A fine-needle aspiration biopsy involves inserting a thin needle to remove a small amount of tissue, sometimes using CT or ultrasound to guide the needle. A core biopsy involves obtaining a sample of tissue with a thick needle or by inserting a thin, lighted tube (laparoscope) into a small incision in the abdomen. Another biopsy method is to remove tissue during an operation.
Calcium
The body's most abundant mineral. Its primary function is to help build and maintain bones and teeth. The body also needs calcium to carry nerve signals, keep the heart functioning, contract muscles, clot blood and maintain healthy skin. Calcium helps control blood acid-alkaline balance, plays a role in cell division, muscle growth and iron utilization, activates certain enzymes, and helps transport nutrients through cell membranes. Calcium also forms a cellular cement called ground substance that helps hold cells and tissues together.
Carbohydrates (Carbohydrate)
The sugars and starches in food. Sugars are called simple carbohydrates and found in such foods as fruit and table sugar. Complex carbohydrates are composed of large numbers of sugar molecules joined together, and are found in grains, legumes, and vegetables like potatoes, squash, and corn.
Carotene
Converted into vitamin A in the body from a yellow pigment that has several forms (i.e., alpha-, beta-, and gamma-carotene).
Celiac Disease (Gluten Sensitivity)
A digestive disease that damages the small intestine and interferes with absorption of nutrients from food. People who have celiac disease cannot tolerate a protein called gluten. Common symptoms include diarrhea, increased appetite, bloating, weight loss, irritability and fatigue. Gluten is found in wheat (including spelt, triticale, and kamut), rye, barley and sometimes oats.
Cholesterol
A waxy, fat-like substance manufactured in the liver and found in all tissues, it facilitates the transport and absorption of fatty acids. In foods, only animal products contain cholesterol. An excess of cholesterol in the bloodstream can contribute to the development of atherosclerosis.
Cobalamin (B12, B-12, Cobalamine, Vitamin B12)
Essential for normal growth and functioning of all body cells, especially those of bone marrow (red blood cell formation), gastrointestinal tract and nervous system, it prevents pernicious anemia and plays a crucial part in the reproduction of every cell of the body i.e. synthesis of genetic material (DNA).
Colon (Colonic)
The part of the large intestine that extends to the rectum. The colon takes the contents of the small intestine, moving them to the rectum by contracting.
Crohn's Disease (Crohn's)
Chronic inflammatory disease of the gastrointestinal tract. The most common symptoms are abdominal pain, often in the lower right area, and diarrhea. Rectal bleeding, weight loss, and fever may also occur. Bleeding may be serious and persistent, leading to anemia.
Cystic Fibrosis
(CF) An incurable genetic disease involving a sticky buildup of mucus in the lungs (which makes breathing difficult and leads to infections), as well as pancreatic insufficiency (which leads to digestive problems). Symptoms include chronic cough producing thick mucus, excessive appetite combined with weight loss, intestinal disorders, salty sweat/skin and pneumonia. Lung-related problems are the most frequent cause of death. CF is a recessive disease, occurring only when a person inherits two mutated copies of the CF gene - one from each parent. Individuals with CF generally have a life expectancy of about 30 years.
Diarrhea
Excessive discharge of contents of bowel.
Electrolyte (Electrolytes)
An element or compound that, when melted or dissolved in water or other solvent, breaks up into ions and is able to carry an electric current.
Enzymes (Enzyme)
Specific protein catalysts produced by the cells that are crucial in chemical reactions and in building up or synthesizing most compounds in the body. Each enzyme performs a specific function without itself being consumed. For example, the digestive enzyme amylase acts on carbohydrates in foods to break them down.
Epithelial
Referring to the cells that line and protect the external and internal surfaces of the body. Epithelial cells form epithelial tissues such as skin and mucous membranes.
Fatty Acids (Fatty Acid)
Chemical chains of carbon, hydrogen, and oxygen atoms that are part of a fat (lipid) and are the major component of triglycerides. Depending on the number and arrangement of these atoms, fatty acids are classified as either saturated, polyunsaturated, or monounsaturated. They are nutritional substances found in nature which include cholesterol, prostaglandins, and stearic, palmitic, linoleic, linolenic, eicosapentanoic (EPA), and decohexanoic acids. Important nutritional lipids include lecithin, choline, gamma-linoleic acid, and inositol.
Folic Acid
A B-complex vitamin that functions along with vitamin B-12 and vitamin C in the utilization of proteins. It has an essential role in the formation of heme (the iron containing protein in hemoglobin necessary for the formation of red blood cells) and DNA. Folic acid is essential during pregnancy to prevent neural tubular defects in the developing fetus.
Gastric
Of, relating to, or associated with the stomach.
Gastrointestinal (GI, GI Tract)
Pertaining to the stomach, small and large intestines, colon, rectum, liver, pancreas, and gallbladder.
Iron
An essential mineral. Prevents anemia: as a constituent of hemoglobin, transports oxygen throughout the body. Virtually all of the oxygen used by cells in the life process are brought to the cells by the hemoglobin of red blood cells. Iron is a small but most vital, component of the hemoglobin in 20,000 billion red blood cells, of which 115 million are formed every minute. Heme iron (from meat) is absorbed 10 times more readily than the ferrous or ferric form.
Magnesium
An essential mineral. The chief function of magnesium is to activate certain enzymes, especially those related to carbohydrate metabolism. Another role is to maintain the electrical potential across nerve and muscle membranes. It is essential for proper heartbeat and nerve transmission. Magnesium controls many cellular functions. It is involved in protein formation, DNA production and function and in the storage and release of energy in ATP. Magnesium is closely related to calcium and phosphorus in body function. The average adult body contains approximately one ounce of magnesium. It is the fifth mineral in abundance within the body--behind calcium, phosphorus, potassium and sodium. Although about 70 percent of the body's magnesium is contained in the teeth and bones, its most important functions are carried out by the remainder which is present in the cells of the soft tissues and in the fluid surrounding those cells.
Malabsorption
Improper utilization of needed and available nutrients, either from impaired digestive function (such as B12 being unabsorbed because of gastritis), impaired absorption (poor Vitamin E absorption because of an inflamed ileum) or impaired transport (the diminished blood proteins of the advanced alcoholic). There are other causes as well.
Mineral (Minerals)
Plays a vital role in regulating many body functions. They act as catalysts in nerve response, muscle contraction and the metabolism of nutrients in foods. They regulate electrolyte balance and hormonal production, and they strengthen skeletal structures.
Pancreas (Pancreatic)
Opposite the liver and behind the stomach, the pancreas has two main functions - to manufacture various enzymes for digestion, and to release hormones to help control the body's use of carbohydrates. It releases insulin to help each cell absorb glucose to burn as energy. In this way, insulin controls the amount of sugar (glucose) in the blood. Proper pancreatic function is very important: too much, too little, or no insulin production can be life-threatening. Some of the chemicals released by the pancreas are not hormones, but stimulate other glands to make hormones. Once again, balance is necessary. Nutritional requirements for the pancreas are many. Research indicates that chromium vitamins C, E, B-complex, calcium, magnesium and potassium are especially important.
Pancreatitis
Inflammation of the pancreas. Symptoms begin as those of acute pancreatitis: a gradual or sudden severe pain in the center part of the upper abdomen goes through to the back, perhaps becoming worse when eating and building to a persistent pain; nausea and vomiting; fever; jaundice (yellowing of the skin); shock; weight loss; symptoms of diabetes mellitus. Chronic pancreatitis occurs when the symptoms of acute pancreatitis continue to recur.
Protein (Proteins)
Compounds composed of hydrogen, oxygen, and nitrogen present in the body and in foods that form complex combinations of amino acids. Protein is essential for life and is used for growth and repair. Foods that supply the body with protein include animal products, grains, legumes, and vegetables. Proteins from animal sources contain the essential amino acids. Proteins are changed to amino acids in the body.
Prothrombin
Protein needed for clotting of the blood.
Serum
The cell-free fluid of the bloodstream. It appears in a test tube after the blood clots and is often used in expressions relating to the levels of certain compounds in the blood stream.
Small Intestine (Small Bowel)
The small intestine lies between the stomach and the large intestine. It is about 6 meters (20 feet) long and its primary function is to digest (break down) food and absorb nutrients (vitamins, minerals, proteins, carbohydrates, and fats). The small intestine makes up more than 70% of the length and 90% of the surface area of the gastrointestinal (GI) tract.
Steatorrhea
The presence of undigested fat in the feces. This may be the result of failing to inoculate fatty foods with enough surfactant (biliary soap) to digest them, the failure of the lower small intestine to absorb them, or simply too much fat for even normal digestion to handle. Sometimes this can indicate liver, gall bladder or lipid metabolism diseases. Usually the causes are subclinical and treatable with less invasive approaches such as herbs.
Last updated: Nov 08, 2009
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