Malabsorption Syndrome

The food that we eat must be absorbed properly in order to benefit from it, but in the case of malabsorption, there’s a problem in the absorption process, and that could lead to serious complications.

Malabsorption syndrome

Malabsorption syndrome is a disorder that prevents the digestive system from working properly and absorbing all the nutrients from the food we eat as it should.

Types of malabsorption syndrome

• Malabsorption of all types of nutrients: it’s caused by certain gastrointestinal disorders, such as celiac disease and inflammatory bowel disease.
• Fat malabsorption: it’s a prevalent kind of malabsorption and leads to fatty stools because the fats will pass into the intestines instead of being absorbed. This type causes malabsorption of fat-soluble vitamins (A, D, E & K). Sometimes, fat malabsorption could occur due to a lack of bile (responsible for digesting fats) from diseases in the gallbladder, bile ducts, or liver, and it could also result from leaving leftover bile acids in the small intestines (bile acid malabsorption), which then pass to the colon and trigger it to secrete water, which causes chronic diarrhea.
• Carbohydrate (sugar) malabsorption: when sugars aren’t properly absorbed, they get fermented and cause bloating and gas.
• Protein malabsorption: this kind usually occurs as a result of a particular intolerance, such as gluten intolerance and milk protein intolerances.

Causes of malabsorption syndrome

• Food intolerances: some people might have congenital intolerances to certain nutrients, such as lactose intolerance.
• Damage in the mucous lining of the small intestines: this lining has a role in secreting digestive enzymes and absorbing liquefied food in order to transfer it to the bloodstream. Usual causes include inflammatory bowel diseases like Crohn’s disease and ulcerative colitis, autoimmune diseases like celiac disease, infectious diseases like Whipple’s disease, alcohol use disorder, radiation and chemo therapy, overusing certain medications, short bowel syndrome, and Zollinger-Ellison syndrome.
• Gallbladder, liver, and pancreas illnesses: these organs are essential in the digestive process. The pancreas produces essential digestive enzymes, and the liver and gallbladder make and store bile. Diseases that affect these organs and, therefore, lead to malabsorption include cystic fibrosis, pancreatic insufficiency, bile duct blockage, gallbladder disease, and liver disease.
• Lymphatic system disorders: lymph vessels are the path in which the small intestines transfer fats into the bloodstream. Diseases, like lymphoma and intestinal lymphangiectasia, affect this process.

Symptoms of malabsorption syndrome

In the beginning of malabsorption, symptoms of indigestion manifest, such as:

• Bloating and gas.
• Abdominal pain and distension.
• Nausea and vomiting.
• Diarrhea and fatty stools.
• With time, malabsorption leads to malnutrition.

Macronutrient (protein, fat, and carbohydrate) malabsorption manifests as:

• Losing weight without trying.
• Muscle wasting.
• Anemia.
• Easily bruising.
• Dehydration.
• Frequent infections.
• Hair loss and brittle hair.
• Skin lesions and dry skin.
• Edema.
• Delayed growth in children.
• Irregular periods in females.
• Extreme tiredness, apathy, and irritability.

Micronutrients (vitamins and minerals) malabsorption might manifest as:

• Weak bones and bone pain.
• Increased bleeding.
• Night blindness.
• Weakness, paleness, and dizziness.
• Red and sore tongue.

Diagnosis of malabsorption syndrome

• Blood, stool, sweat, and breath tests.
• Imaging tests.
• A biopsy from the small intestines.

Treatment of malabsorption syndrome

• Treating malabsorption depends on the cause.
• In general, the patient must take nutritional supplements, either orally, intravenously, or through a tube.
• Some patients might need specific digestive enzyme replacement therapy.