what is malabsorption
inadequate absorption of nutrients in the GIT
consequence - patient becomes malnourished
two types of malabsorption
mucosal and premucosal
whats included in mucosal malabsorption
crohns
coaliac
surgeryw
whats included in premucosal malabsorption
pancreatitis
CF
lactose deficiency
mucosal - crohns
malabsorption linked to inflammation
deficiencies include -
- iron
- B12/B9
- vitamin D and calcium
mucosal - coeliac
autoimmune condition
gluten activates an abnormal mucosal response
symptoms - fatigue, GI disturbance, weight loss
diagnosed via blood tests
complications include anaemia, osteoporosis
mucosal - short bowel syndrome
mostly due to surgery but can be congenital
depends on how much of the bowel is removed
less SA available for absorption
for drugs absorbed in ileum - higher doses may be required
premucosal - chronic pancreatitis
chronic inflammation of the pancreas leading to impaired function
strong association with excess alcohol
tests - faecal elastase
can also test for fat soluble vitamin deficiencies
pre mucosal - CF
inherited genetic condition
decreased Cl secretion and increased Na absorption
consequences - steatorrhoea, osteoporosis, malnutrition, weight loss
pre mucosal- lactase deficiency
primary - gradual decline in lactase enzyme activity with age
secondary - results from infection
congenital
developmental - premature babies, normally goes away with age
mucosal and premucosal - SIBO
small intestine bacterial overgrowth
causes wide range of deficiencies
can be caused by motility disorders , pancreatitis
mucosal / premucosal - fat malabsorption
problem with digestion or absorption
more common in coeliac or crohns
results in deficiency of fat soluble vitamins (A,D,E,K)
causes stearrhoea
signs of vitamin D / Ca deficiency
osteoporosis
signs of vitamin A deficiency
night blindness
signs of vitamin E deficiency
neurological problems
signs of vitamin K deficiency
bleeding/ clotting problems
