is inadequate assimilation of dietary substances due to defects in digestion,absorption, or transport. Malabsorption affects macronutrients (e.g., proteins, carbohydrates, fats) or micronutrients (e.g., vitamins, minerals), causing excessive fecal excretion and producing nutritionaldeficiencies and GI symptoms.
a group of symptoms resulting from disorders in the intestines' ability toabsorb nutrients from foods eaten. It may lead to loss of appetite, weight loss, swollen abdomen,muscle cramps, bone pain, and fat in the feces. Anemia, weakness, and tiredness can occur becauseiron, folic acid, and vitamin B12are not absorbed in right amounts. Among the many conditionscausing this syndrome are stomach or small bowel surgery, celiac disease, tropical sprue, cysticfibrosis, Whipple's disease, and intestinal lymphangiectasia, a disease involving the grouping of thelymph ducts in the intestines.
Digestion and absorption occur in three phases: (1) intraluminal hydrolysis of fats, proteins, andcarbohydrates by enzymes (bile salts enhance the solubilization of fat in this phase) (2) digestion by brush border enzymes and uptake of end-products; (3) lymphatic transport of nutrients. Malabsorptionoccurs when any of these phases is impaired.
A) Incomplete digestive process, which may be due to:
- Damage or dysfunction of the pancreas- Reduction or absence of bile salts to emulsify fats for absorption; this can occur in billiaryobstruction, liver disease or extensive resection of the small bowel- Excessive transit time, impairing optimal absorption; this can occur in disorders of metabolic rates,inflammatory bowel disease and even prolonged and excessive stress
B) Faulty absorption of nutrients due to:
- Damage to the absorptive surfaces, as in inflammatory bowel disease and coeliac disease- Impaired enzyme activity e.g. in lactose intolerance- Resection of the absorptive surfaces e.g. in inflammatory bowel disease.
The Major Malabsorption Syndromes:
It’s the inability to properly digest food due to a lack of digestive enzymes made by the pancreas. EPIis found in patient afflicted with cystic fibrosis. It is caused by a progressive loss of the pancreaticcells that make digestive enzymes. Chronic pancreatitis is the most common cause of EPI in humans.
Often this is treated with Pancreatic Enzyme Products (PEPs), such as pancrelipase, that are used to breakdown fats (lipases), proteins (proteases) and carbohydrates (amylases) into units that can bedigested by those with EPI.