Malabsorption syndromes
Pathophysiology of malabsorption
[edit | edit source]- Impaired absorption of nutrients, either congenital or acquired
- Four steps for normal nutrient absorption:
- Intra-luminal digestion (cholestasis, pancreatic insufficiency, bacterial overgrowth, anatomical)
- Luminal and brush border processing
- Absorption into the intestinal mucosa via trans-epithelial transport (coeliac, IBD, short bowel syndrome, radiation damage)
- Transport into the circulation via lymphatic vessels
Presentation
[edit | edit source]- Diarrhoea
- Flatus
- Abdominal pain
- Weight loss
Investigation
[edit | edit source]- Bloods including nutritional screening
- Faecal fat excretion
- Most common indicator of global malabsorption
- Based on stool of three days
- Should not be >6g/day
- Coeliac serology
- Lactose breath hydrogen test
- Scopes
- Pill cam
- MRE