MALABSORPTION SYNDROME all nutrients, or you can have

particular difficulties absorbing

 Malabsorption syndrome is a
certain kinds of nutrients. Whatever
digestive disorder that prevents your
you can’t absorb will pass undigested
body from effectively absorbing
in your stools. People with
nutrients from your food. It has
malabsorption syndrome often have
many causes, but most of them
diarrhea as a side effect, which can
involve damage to the mucous lining
make malabsorption worse. With
of your small intestine, where most
diarrhea, food moves too fast
absorption happens.
through your bowels for nutrients to
What is malabsorption? be absorbed.
 In the short term, malabsorption will
 Malabsorption is an umbrella term
cause gastrointestinal distress from
for a wide range of disorders that
the inability to digest certain foods.
affect your ability to absorb nutrients
Over time, your body will start to
from your food.
show signs of deficiency in those
 Malabsorption can lead to
nutrients that you can’t absorb.
indigestion and even malnutrition —
Deficiencies in any of the
not from a lack of eating enough
macronutrients — protein, fats or
nutrients, but from an inability to
carbohydrates — will cause signs of
absorb them. You can think of
undernutrition, such as muscle
digestion as a three-part process. The
wasting and reduced immunity.
first part is breaking down food into
Deficiencies in micronutrients —
digestible pieces. The second part is
vitamins and minerals — may affect
absorbing all the nutrients in your
your eyes, bones, skin and hair.
food. And the third part is
eliminating the waste that is left over
when all the good stuff has been
What are the different types of
absorbed.
malabsorption disorders?
 If you have digestive difficulties, the
problem could be in any of these  Some gastrointestinal diseases, such
three stages (or several). as celiac disease and inflammatory
Malabsorption disorders cover the bowel disease, cause general
second stage. They include specific malabsorption of all kinds of
food intolerances caused by enzyme nutrients. In other cases, you may
deficiencies, as well as various have particular difficulties absorbing
gastrointestinal diseases that affect a particular kind of nutrient. Some of
your digestive system. these types include:
What happens if you have Carbohydrate malabsorption
malabsorption?
-Some people are sensitive to one or several
 You can have general malabsorption, carbohydrates (sugars). You may experience
which affects your ability to absorb this primarily as gas pain and abdominal
bloating. Carbohydrates that aren’t fully  Abdominal pain.
absorbed in your small intestine get  Abdominal distension.
fermented by the bacteria in your colon. The  Bloating.
bacteria break them down into gasses and  Gas.
short-chain fatty acids. The gasses cause  Nausea and vomiting.
intestinal gas, and the short-chain fatty acids  Diarrhea.
 Steatorrhea (fatty stools).
cause fatty stools.
Fat malabsorption Over time, signs of malnutrition will appear.

-This is a common type of malabsorption, Macronutrient undernutrition can look like:

possibly because it has so many causes. Fats
that aren’t absorbed in your small intestine  Unintentional weight loss.
pass to your colon, causing fatty stools  Muscle wasting.
(steatorrhea). Fatty stools are greasy and  Frequent infections.
runny and particularly smelly. They may be  Bruising easily.
light-colored and float. Fat malabsorption  Dry skin and skin lesions.
also leads to the malabsorption of fat-soluble  Dry hair and hair loss.
vitamins (A, D, E and K).  Dehydration.
 Edema (swelling with fluid).
Bile acid malabsorption  Anemia (weakness,
lightheadedness).
-Sometimes fat malabsorption results from a  Irritability, apathy and fatigue.
lack of bile from diseases of the gallbladder,  Amenorrhea (skipped periods) in
bile ducts or liver. But sometimes it results women.
from another problem, leaving leftover bile  Growth delays in children.
acids in your small intestine and passing
these on to your colon. This side effect is Micronutrient undernutrition can appear as:
called bile acid malabsorption. Leftover bile
salts trigger your colon to secrete water,  Night blindness (vitamin A
causing chronic diarrhea. deficiency).
 Weak bones and bone pain (vitamin
Protein malabsorption D deficiency).
 Bleeding gums and nosebleeds
-Protein malabsorption doesn’t usually occur (vitamin K deficiency).
by itself unless you have a particular  Sore, red tongue (vitamin b12
intolerance. Examples of this include milk deficiency).
protein intolerances and gluten intolerance.  Paleness, weakness and dizziness
(vitamin deficiency anemia).

What are the symptoms of malabsorption

syndrome? What are the main causes of
malabsorption syndrome?
Malabsorption syndrome will look like
indigestion at first, with symptoms such as:
You may have temporary malabsorption
during a bout of stomach flu, but
malabsorption disorders that last a long time
occur from an underlying condition that
you’ve had for a long time. Malabsorption
has many causes, but they fall into a few
general categories.
Damage to the lining of the small intestine
Your small intestine is where most of your
nutrient absorption happens. (A small
amount happens in your large intestine.)
The mucous lining of your intestinal walls is
involved in both secreting digestive enzymes
and absorbing liquefied food into your
bloodstream. But inflammation (enteritis)
and injury can damage this mucous
membrane. The damage can be temporary
(acute) or long-lasting (chronic). Some
causes include:
 Infectious diseases such
as Whipple’s disease and tropical
sprue.
 Inflammatory bowel diseases such
as ulcerative colitis and Crohn’s
disease.
 Autoimmune diseases such as celiac
disease.
 Overuse of certain drugs and
medications.
 Alcohol use disorder.
 Radiation therapy and chemotherapy.
 Short bowel syndrome.
 Small intestinal bacterial
overgrowth (SIBO).
 Overproduction of stomach acid, as
in Zollinger-Ellison syndrome.
Pancreas, gallbladder and liver diseases
Your pancreas, liver and gallbladder all
work together with the small intestine to
break down food. Your pancreas makes
important digestive enzymes, while your
liver and gallbladder make and store bile,
which is important for digesting fats. These
organs deliver their substances to your small
intestine when food is present. But if a
disease stops them from doing their jobs,
your small intestine won’t be able to break
food down enough to absorb it. Examples
include:
 Pancreatic insufficiency.
 Cystic fibrosis.
 Bile duct blockages.
 Gallbladder diseases.
 Liver disease.
Lymphatic system diseases
Your small intestine absorbs fats into your
bloodstream through lymph vessels.
Diseases of the lymphatic system that block
these vessels can compromise the absorption
of fats. Intestinal lymphangiectasia
and lymphoma are two examples of this.
Food intolerances
Malabsorption of certain carbohydrates or
proteins can occur as a side effect of
gastrointestinal disease. (Fructose
malabsorption is a common example.) But
sometimes people are born lacking the
necessary enzymes to break down certain
nutrients. (Lactose intolerance is the most
common example of this.)
DIAGNOSIS AND TESTS
How do you know if you have
malabsorption?
As with many gastrointestinal diseases,
diagnosing malabsorption can be a process.
Your healthcare provider will begin by
examining you and considering your health
history and symptoms. If you have a known
history of chronic gastrointestinal disease or
surgery, that may raise suspicions of
malabsorption.
Some symptoms, such as fatty stools and
chronic diarrhea, or evident anemia and
muscle wasting, are highly suggestive of
malabsorption and malnutrition. Other cases
may be more subtle. Your healthcare
provider will follow up with appropriate
tests to narrow down the causes of your
distress.
What tests are used to diagnose
malabsorption?
 Breath tests. - help diagnose
specific carbohydrate intolerances,
such as lactose intolerance, as well as
general small intestinal bacterial
overgrowth.
 Stool tests. - can measure the fat
content in your stools to diagnose fat
malabsorption. It can also reveal
parasitic infections, and it can show
evidence of decreased pancreatic
function.
 Blood tests. - show specific nutrient
deficiencies that may result from
malabsorption, as well as markers of
specific conditions such as celiac
disease.
 Sweat test. This is a specific test for
cystic fibrosis.
 Imaging tests. Your healthcare
provider may want to have a look at
your digestive organs to look for
signs of disease. They might take
a GI X-ray exam, endoscopic
ultrasound or video capsule
endoscopy.
 Small intestinal biopsy. - can help
show evidence of damage to the
mucosa. They can take a sample
during an endoscopic exam.
MANAGEMENT AND TREATMENT
How is malabsorption syndrome treated?
Malabsorption syndrome can have many
underlying causes and also a wide range of
effects. Your treatment will be based on
these factors.
To treat the effects of malabsorption, you
may need supplemental nutrition, either in
an oral formula, by tube or through a vein.
You may need specific digestive enzymes
replaced, either to treat a food intolerance or
general pancreatic insufficiency. If you have
bile acid malabsorption, you may need bile
acid sequestrants (food additive) to help
prevent diarrhea.
Treating the underlying cause of
malabsorption can be more complicated. If
it’s only from a food intolerance, you may
simply have to adjust your diet. Simple
infections can be treated with antibiotics.
But chronic diseases will require more
particular treatment. Sometimes there is no
direct cure, but lifestyle adjustments can
help relieve symptoms.
OUTLOOK / PROGNOSIS
A note from Cleveland Clinic
Most people experience occasional
indigestion, bloating, gas or diarrhea. If
something you eat doesn’t agree with you,
you may have temporary symptoms, but
they typically go away on their own. This
type of indigestion is usually no cause for
real concern. But if you have chronic
symptoms, there may be something larger
going on. Persistent diarrhea in particular
should always be taken seriously.
Malabsorption can be a hidden cause of
malnutrition. Since malnutrition occurs
gradually, you might not notice it until it is
advanced, especially if you have an adequate
diet. This is especially dangerous for
children, who have higher nutritional needs
to support their growth and development,
and who may not know how to tell you
about their symptoms. If your child shows
signs of recurring gastrointestinal distress,
especially loose stools, make sure to see
your healthcare provider to rule out
malabsorption.