Malabsorption

Impaired absorption of nutrients from the gastrointestinal tract.

• Mucosal: Coeliac disease, tropical sprue, Crohn’s disease, radiation enteritis, Whipple’s disease.

• Luminal: Pancreatic insufficiency (chronic pancreatitis, cystic fibrosis), bile salt deficiency (cirrhosis, cholestasis).

• Postoperative: Gastric bypass, bowel resection.

• Infective: Giardiasis, bacterial overgrowth, tuberculosis.

• Steatorrhoea (pale, smelly, sticky stools).

• Weight loss despite normal or increased appetite.

• Anaemia and fatigue.

• Bruising and bleeding due to vitamin K deficiency.

• Bone pain and fractures due to vitamin D and calcium malabsorption.

• Peripheral neuropathy due to vitamin B12 deficiency.

• Blood tests: Full blood count, vitamin levels (e.g., B12, D), coagulation profile.

• Stool tests: Faecal fat estimation, faecal elastase (pancreatic function).

• Small bowel biopsy (e.g., for suspected coeliac disease).

• Imaging: Abdominal ultrasound, CT, or MRI.

• Hydrogen breath test: To detect bacterial overgrowth.

• Endoscopy and colonoscopy with biopsies if needed.

• Treatment is focused on the underlying cause (e.g., gluten-free diet for coeliac disease).

• Pancreatic enzyme supplementation: For pancreatic insufficiency.

• Bile salt replacement for bile salt deficiency.

• Dietary modifications: High-calorie diet, vitamin and mineral supplementation.

• Antibiotics for bacterial overgrowth or specific infections.

• Nutritional deficiencies leading to conditions like osteoporosis, anaemia, or neuropathies.

• Growth retardation in children.