Malabsorption syndrome refers to a number of disorders in which the intestine’s ability to absorb certain nutrients, such as vitamin B12 and iron, into the bloodstream is negatively affected.
Proteins, carbohydrates, fats, and most fluids are absorbed in the small intestine (small bowel). Malabsorption syndrome occurs when something prevents the bowel from absorbing important nutrients and fluids. The problem may be caused by inflammation, disease, or injury. Sometimes, the condition may be the result of the body’s failure to produce enzymes needed to digest some foods. Factors that may cause malabsorption syndrome include:
- antibiotic use
- conditions such as celiac disease, chronic pancreatitis, cystic fibrosis, and dairy protein allergies
- congenital (birth) defects or diseases of the gall bladder, liver, or pancreas
- damage to the intestine (from infection, inflammation, injury, or surgery)
- radiation therapy (which may injure the mucosal lining of the bowel)
Disorders that Can Lead to Malabsorption
There are a number of (fairly uncommon) disorders that result in malabsorption. These include:
- Short bowel syndrome: The condition may be a birth defect or the result of surgery. The ability of the bowel to absorb nutrients is affected any time its surface area is reduced.
- Tropical sprue: Most common in Southeast Asia, the Caribbean, and India. Symptoms may include anemia, diarrhea, sore tongue, and weight loss. The condition may be related to environmental factors such as toxins in food, infection, or parasites.
- Whipple’s disease: A rare disease that usually affects middle-aged men. The condition may be caused by a bacterial infection. Symptoms include chronic fever, darkening of skin pigment, diarrhea, joint pain, and weight loss.
Symptoms of malabsorption syndrome will be different depending on the nutrients that are not properly absorbed. Deficiencies and resulting symptoms include:
- fats: light-colored, foul-smelling stools that are soft and bulky. Such stools are difficult to flush and may float or stick to the sides of the toilet bowl.
- proteins: fluid retention (edema), dry hair, or hair loss
- sugars: bloating, flatulence, or explosive diarrhea
- vitamins: anemia, malnutrition, low blood pressure, weight loss, and wasting
Risk factors for malabsorption include:
- excessive alcohol consumption
- family history of cystic fibrosis or malabsorption
- intestinal surgery
- use of certain medications including laxatives or mineral oil
- travel to Southeast Asia, the Caribbean, and India (see “Tropical Sprue” above)
A doctor may suspect malabsorption syndrome if the patient suffers chronic diarrhea, nutrient deficiencies, or has significant weight loss despite eating a healthy diet. Laboratory tests are used to confirm the diagnosis. Tests that measure fat in stool samples are the most reliable because malabsorption of fat is usually present in each of the disorders. Other tests can measure malabsorption of specific nutrients such as vitamins. If an abnormality in the bowel lining is suspected, your doctor may perform a biopsy as well.
Nutrient and fluid replacement are the first step in treating malabsorption syndrome. Hospitalization may be required in the most extreme cases.
If you have been diagnosed with malabsorption syndrome, you should consult with a dietician to make sure you are getting proper nutrients. You should eat several small meals throughout the day that are rich in carbohydrates, fats, minerals, proteins, and vitamins. You will be monitored for signs of dehydration, which may include dizziness or weakness, dry mouth, skin or tongue, increased thirst, and low urine output.