Definition

Malabsorption

is when the body has trouble absorbing certain vitamins, minerals, carbohydrates, proteins, or fats even though food is digested.

Causes

Malabsorption is associated with a number of diseases that affect the intestines or other areas of the gastrointestinal tract, such as:

• Lactose intolerance
• Celiac disease
• Intestinal parasites
• HIV/AIDS, cancer, or treatment for those conditions
• Whipple disease or other bacterial infections
• Crohn’s disease
• Cystic fibrosis
• Inadequate digestion due to:
  • Bacterial overgrowth syndrome
  • Gastric resection—removal of all or part of the stomach
  • Inadequate function of the pancreas
  • Excessive production of gastric acid
  • Short bowel syndrome or previous bowel removal
  • Liver disease

Risk Factors

Factors that may increase your chance of malabsorption include:

• Medical conditions affecting the intestine such as celiac disease, cystic fibrosis, or Crohn’s disease
• Use of laxatives
• Excessive use of antibiotics
• Intestinal surgery
• Alcohol use disorder
• Travel to countries with high incidence of intestinal parasites

Symptoms

Malabsorption may cause:

• Weight loss
• Abdominal distention and bloating
• Diarrhea
• Flatulence
• Bulky, foul-smelling stools
• Weakness and fatigue
• Swelling or fluid retention
• Muscle weakness

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.

Your bodily fluids, waste products, and tissues may be tested. This can be done with:

• Blood tests
• Stool tests
• Urine tests
• Hydrogen breath test
• Small bowel biopsy

Images may be taken of your bodily structures. This can be done with x-rays.

Your pancreas may be tested. This can be done with a pancreatic function test.

Treatment

In some people, the specific underlying condition must be treated in order to reverse the malabsorption. Other conditions cannot always be treated such as cystic fibrosis, short bowel, or pancreatic insufficiency.

Depending on the cause and severity of the malabsorption, you may need to make up for nutritional deficiencies by consuming additional nutrients through foods or supplements. A diet rich in vitamins and minerals along with increased quantities of fat, protein, or carbohydrate may be required. Nutrient supplementation may include folate, iron, and vitamin B12. In some cases, nutrients may be given by IV.

Prevention

Conditions that cause malabsorption need to be recognized and managed. Work with your doctor and follow the recommended treatment plan to decrease malabsorption complications.

National Organization for Rare Disorders http://www.rarediseases.org

Health Canada http://www.hc-sc.gc.ca

Bacterial overgrowth syndrome. Merck Manual Professional Version website. Available at:
http://www.merckmanuals.com/professional/gastrointestinal_disorders/malabsorption_syndromes/bacterial_overgrowth_syndrome.html
Updated May 2014. Accessed June 19, 2014.

Chronic diarrhea. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated June 16, 2014. Accessed June 19, 2014.

Diarrheal diseases—acute and chronic. American College of Gastroenterology website. Available at:
http://patients.gi.org/topics/diarrhea-acute-and-chronic
Updated December 2012. Accessed July 19, 2014.

Overview of malabsorption. Merck Manual Professional Version website. Available at:
http://www.merckmanuals.com/professional/gastrointestinal_disorders/malabsorption_syndromes/overview_of_malabsorption.html
Updated May 2014. Accessed July 19, 2014.