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Malabsorption Syndrome

Malabsorption Syndrome

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Published by Hassan.shehri
Malabsorption Syndrome: a group of symptoms resulting from disorders in the intestines' ability to absorb nutrients from foods eaten.
Malabsorption Syndrome: a group of symptoms resulting from disorders in the intestines' ability to absorb nutrients from foods eaten.

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Published by: Hassan.shehri on Nov 26, 2007
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05/13/2013

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MALABSORPTION SYNDROME
Hassan Mohammad Al-Shehri2051040085To Department of Pathology KFUDr. Tariq Hashm2007-11-26To other students of KFU 4
th
year please DO NOT COPY AND PASTE myassignment. However, you may take general points if you wish and start from there.Again please do not take the exact content and give it to doctor under your name. cuzI’ll give it to doctor and if u do the same we well take
0
both of us.If you are not 4
th
year student at KFU you may do what ever you want with it.
1
 
Malabsorption Syndrome
 Malabsorption
:
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.
 Malabsorption Syndrome
:
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.
Pathophysiology:
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.
Causes:
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.
Treatment
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.
(2)Biliary Obstruction:
2
 
Biliary obstruction refers to the blockage of any duct that carries bile from the liver to the gallbladder or from the gallbladder to the small intestine. Biliary obstruction separated into:
(I) Intrahepatic
Intrahepatic cholestasis generally occurs at the level of the hepatocyte or biliary canalicular membrane. Causes include hepatocellular disease (e.g., viral hepatitis, drug-induced hepatitis), drug-induced cholestasis, biliary cirrhosis, and alcoholic liver disease.
(II) Extrahepatic
Extrahepatic obstruction to the flow of bile may occur within the ducts or secondary to externalcompression. Overall, gallstones are the most common cause of biliary obstruction.
(3)Lactose Intolerance:
A disorder characterize by the inability to digest milk sugar (lactose) because of an enzyme lactasedeficiency.
There are three major types of lactose intolerance:
1.
 Primary lactose intolerance
: Environmentally induced by weaning in non dairy consumingsocieties. Where industrialized and commercial dairy is uncommon, milk consumption beyondinfancy is not common.2.
 Secondary lactose intolerance
: Environmentally induced, resulting from certain gastrointestinaldiseases, including exposure to intestinal parasites such as giardia.3.
Congenital lactase deficiency
: A genetic disorder which prevents enzymatic production of lactase.Present at birth, and diagnosed in early infancy.
Symptoms and Signs:
The effects of unabsorbed substances include diarrhea, steatorrhea, abdominal bloating, and gas.Other symptoms result from nutritional deficiencies. Patients often lose weight despite adequate foodintake.Chronic diarrhea is the most common symptom. Steatorrhea is the hallmark of malabsorption.Steatorrhea produces foul-smelling, pale, bulky, and greasy stools.Severe vitamin and mineral deficiencies occur in advanced malabsorption symptoms are related to thespecific nutrient deficiency.
Treatment:
The diet must be adjusted to restrict such foods as milk, cheese, butter, and any other productscontaining milk.
3

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