Clinical features and diagnosis of malabsorption
- Joel B Mason, MD
Joel B Mason, MD
- Professor of Medicine and Nutrition
- Tufts University Schools of Medicine and Nutrition
- USDA Human Nutrition Research Center at Tufts University
- Vladan Milovic, MD, PhD
Vladan Milovic, MD, PhD
- Associate Professor of Medicine
- Head, Department of Gastroenterology & Oncology Reha-Zentrum Bad Reichenhall /
- Bayerisch Gmain Klinik Hochstaufen Bayerisch Gmain
- Bayern, Germany
Malabsorption refers to impaired absorption of nutrients . It can result from congenital defects in the membrane transport systems of the small intestinal epithelium or from acquired defects in the epithelial absorptive surface. Another factor that can interfere with nutrient absorption is maldigestion, which is due to impaired digestion of nutrients within the intestinal lumen or at the terminal digestive site of the brush border membrane of mucosal epithelial cells.
Although malabsorption and maldigestion are pathophysiologically different, the processes underlying digestion and absorption are interdependent. As a result, in clinical practice the term malabsorption has come to denote derangements in both processes.
Three steps are required for normal nutrient absorption :
●Luminal and brush border processing
●Absorption into the intestinal mucosa
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- CLINICAL FEATURES
- Imaging tests
- - Endoscopy and pancreatic imaging
- - Barium studies
- - Wireless capsule endoscopy
- TESTS FOR FAT MALABSORPTION
- Fecal fat determination
- - Sudan III stain
- - Near infrared reflectance analysis
- - Acid steatocrit
- TESTS FOR CARBOHYDRATE MALABSORPTION
- D-xylose test
- Lactose tolerance test
- Breath tests
- PROTEIN MALABSORPTION
- ADDITIONAL TESTS
- Schilling test
- SeHCAT test
- Tests for bacterial overgrowth
- Tests for pancreatic insufficiency
- SUMMARY AND RECOMMENDATIONS