MALABSORPTION SYNDROME
RAHUL SAJEEN
19M3836
DIAGNOSIS:
C L I N I C A L H I S T O RY
Symptom Assessment:
• Diarrhea: Often chronic, can be watery, fatty (steatorrhea), or associated
with urgency.
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• Weight Loss: Unintentional and significant weight loss.
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• Abdominal Symptoms: Cramping, bloating, and flatulence.
• Nutritional Deficiencies: Symptoms related to deficiencies, such as:
Anemia (fatigue, pallor)
Osteoporosis or bone pain (vitamin D deficiency)
Peripheral neuropathy (vitamin B12 deficiency).
Dietary History:
• Inquire about dietary habits, food intolerances (e.g., lactose,
gluten), and changes in appetite or weight.
Medical History:
• Previous gastrointestinal disorders, surgeries, infections, or family 3
history of autoimmune diseases.
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P H Y S I C A L E X A M I N AT I O N
General Appearance:
• Signs of malnutrition (wasting, cachexia).
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Abdominal Examination:
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• Tenderness, distension, or palpable masses.
Signs of Nutritional Deficiencies:
• Anemia, glossitis, cheilosis, edema (due to protein deficiency)
L A B O RAT O RY T E S T S
Stool Tests:
• Fecal Fat Test: Measures the fat content in stool. >7 grams of fat per
day indicates fat malabsorption.
• Stool Osmotic Gap: A high gap (>100) suggests osmotic diarrhea.
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Blood Tests:
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• Complete Blood Count (CBC): Look for anemia.
• Serum Electrolytes: Check for electrolyte imbalances.
Nutritional Panel:
Levels of vitamins (B12, folate, D, A, E) and minerals (iron, calcium).
• Liver Function Tests: Assess liver health and biliary function.
IMAGING STUDIES
• Abdominal Ultrasound: To evaluate for structural
abnormalities (e.g., gallstones, pancreatitis).
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• CT Scan or MRI: To visualize the GI tract for tumors,
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strictures, or other abnormalities.
ENDOSCOPIC PROCEDURES
Upper GI Endoscopy with Biopsy:
• Essential for diagnosing celiac disease (looking for villous atrophy)
or other mucosal conditions.
Colonoscopy: 7
• Useful for evaluating inflammatory bowel diseases (e.g., Crohn’s
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disease, ulcerative colitis).
SPECIALIZED TESTS
Hydrogen Breath Test:
• Assesses carbohydrate malabsorption, especially lactose
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intolerance.
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D-xylose Absorption Test:
• Evaluates the intestinal absorptive capacity; low levels suggest
mucosal disease.
MANAGEMENT OF MALABSORPTION
SYNDROME
Dietary Modifications
• Celiac Disease: Strict lifelong gluten-free diet.
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• Lactose Intolerance: Avoidance of lactose-containing products or
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use of lactase supplements.
• Fat Malabsorption: Low-fat diet; consider medium-chain
triglycerides (MCTs) for easier absorption.
N U T R I T I O N A L S U P P O RT
Vitamin and Mineral Supplementation: Based on identified
deficiencies:
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• Vitamin B12 injections for pernicious anemia.
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• Iron supplements for iron-deficiency anemia.
• Calcium and vitamin D for bone health.
• Protein Supplements: For individuals with protein malabsorption or low
intake.
• Enteral Nutrition: In cases where oral intake is inadequate, consider
enteral feeding via tube or total parenteral nutrition (TPN) in severe cases.
T R E A T I N G U N D E R LY I N G C A U S E S
• Pancreatic Insufficiency: Use of pancreatic enzyme replacement
therapy (e.g., pancrelipase).
• Bacterial Overgrowth: Antibiotic therapy, such as rifaximin or 11
metronidazole, as indicated.
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• Inflammatory Bowel Disease: Corticosteroids,
immunosuppressants, or biologics based on disease severity.
• Surgical Interventions:
• Resection for tumors or strictures.
• Biliary surgery for gallstones or obstructions.
MONITORING AND FOLLOW-UP
• Regular follow-up visits to monitor weight, nutritional status, and
symptom improvement.
• Repeat laboratory tests to assess for ongoing deficiencies and 12
adjust dietary and supplementation plans accordingly.
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