Malabsorption

Malabsorption

manifestations of disorders affecting digestion or absorption of nutrients
1. abnormal stools
  1. true malabsorption stool
    1. hard to flush down the toilet
    2. odour pervades whole house
  2. colour is poor guide to abnormality
2. failure to thrive or poor growth
  1. seen in most but not all cases
  2. inapprop to ix kids for malabsorption as a cause of failure to thrive when dietary intake is low & other sx absent
3. specific nutrient deficiencies
reliable dietary assessment is important
can be pan-malabsorption
1. poor absorption of many nutrients
can be highly specific
1. e.g. Zn malabsorption
  1. acrodermatitis enteropathica
causes of nutrient malabsorption
1. cholestatic liver disease or biliary atresia
  1. bile salts no longer enter duodenum in bile
    1. -> defective solubilisation of products of triglyceride hydrolysis
      1. -> fat and fat-soluble malabsorption
2. exocrine pancreatic dysfunction
  1. e.g cystic fibrosis
  2. absent lipase, proteases & amylase
    1. -> defective triglyceride, protein and starch digestion (pan-malabsorption)
3. small intestinal mucosal disease
  1. loss of absorptive surface area
    1. e.g. coeliac disease
  2. specific enzyme defects
    1. e.g. lactase deficiency ff gastroenteritis
      1. common in Black & Oriental races
  3. specific transport defects
    1. e.g. glucose-galactose malabsorption
      1. severe life-threatening diarrhoea with 1st milk feed
    2. acrodermatitis enteropathica
      1. zinc malabsorption
        erythematous rash of mouth & anus
4. lymphatic leakage or obstruction
  1. chylomicrons (containing absorbed lipid) unable to reach thoracic duct & sys circulation
    1. e.g. intestinal lymphangiectasia (abnormal lymphatics)
5. short bowel syndrome
  1. small intestinal resection
    1. due to congenital abnormalities or necrotising enterocolitis
    2. -> nutrient, water & electrolyte malabsorption
6. loss of terminal ileal function
  1. e.g. resection or Crohn disease
  2. absent bile acid and absent B12 absorption

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	Criado por v.djabatey quase 11 anos atrás