Malabsorption syndrome refers to disorders where the small intestine cannot absorb enough nutrients and fluids. This can lead to deficiencies in vitamins, minerals, proteins, carbohydrates, and fats. Causes include infections, structural defects, mucosal abnormalities, enzyme deficiencies, and other systemic diseases affecting the GI tract. Symptoms vary based on the deficient nutrients but commonly include fatty stools, weight loss, and malnutrition. Diagnostic tests include blood tests, stool tests, imaging, and biopsy. Treatment focuses on replacing lost nutrients, treating any underlying causes, and modifying diet.

1. MALABSORPTION
SYNDROME

3.  Malabsorption syndrome refers to a number of
disorders in which the small intestine can't
absorb enough of certain nutrients and fluids.
Nutrients that the small intestine often has
trouble absorbing can be macronutrients
(proteins, carbohydrates, and fats),
micronutrients (vitamins and minerals), or both.

4.  Micronutrients, as opposed
to macronutrients (protein, carbohydrates
and fat), are comprised of vitamins and
minerals which are required in small
quantities to ensure normal metabolism,
growth and physical well-being.

6.  Maldigestion means incomplete breakdown
of nutrients in the gastrointestinal tract,
usually due to lack of digestive enzymes.
 Malabsorption means impaired transport of
nutrients from the intestine into the blood.

8. Due to infective agents
 Gastrointestinal tuberculosis is defined as
infection of the peritoneum, hollow or
solid abdominal organs,
and abdominal lymphatics with
Mycobacteriumtuberculosis organisms. Gastroint
estinal tuberculosis is relatively rare in the United
States and is the sixth most common
extrapulmonary location.

9.  The small intestine is a major target in
HIV infection. Small intestinal disease causes
malabsorption of fat and
disaccharides and may contribute to the
weight loss seen in advancing HIV infection.

10.  Parasites: such as intestinal coccidia and
microsporidia in malabsorption syndrome is
limited. All the patients infected with
intestinal coccidia were HIV sero-negative.
Celiac disease is the most common cause
of malabsorption syndrome in both adults
and children.

11.  Celiac disease, sometimes called celiac sprue or
gluten-sensitive enteropathy, is an immune reaction
to eating gluten, a protein found in wheat, barley
and rye. If you have celiac disease, eating gluten
triggers an immune response in your small
intestine.

12.  Whipple disease is a rare bacterial infection
that most often affects joints and digestive
system. Whipple disease interferes with
normal digestion by impairing the breakdown
of foods, such as fats and carbohydrates, and
hampering body's ability to absorb nutrients.

14.  Tropical Sprue is a rare digestive disease in
which the small intestine's ability to absorb
nutrients is impaired (malabsorption).
Consequently, nutritional deficiencies and
abnormalities in the mucous lining of the
small intestine may be present.

16. Due to structural defects
 INFLAMMATORY BOWEL DISEASE (IBD) is a
term for two conditions (Crohn's disease and
ulcerative colitis) that are characterized by
chronic inflammation of the gastrointestinal
(GI) tract.
 Prolonged inflammation results in damage to
the GI tract.

17.  Systemic sclerosis is a chronic autoimmune
disease with an unknown etiology. it is
characterized by abdominal pain, diarrhea,
pseudo-obstruction, malabsorption

18.  Diverticulitis
 Fistulas : A fistula is an abnormal connection
between two hollow spaces (technically, two
epithelialized surfaces), such as blood vessels,
intestines, or other hollow organs. Fistulas are
usually caused by injury or surgery, but they can
also result from an infection or inflammation.

20.  Post gastroctomy, post vagotomy or gastro-
jejunoctomy
 Radiation entritis

21. Due to mucosal abnormalities
 Celiac disease
 Crohn’s disease: Crohn's disease is
an inflammatory bowel disease(IBD). It
causes inflammation of digestive tract, which
can lead to abdominal pain, severe diarrhea,
fatigue, weight loss and malnutrition.

22.  Cow’s milk intolerance
 Soya milk intolerance
 Fructose malabsorption: fructose intolerance,
occurs when cells on the surface of the intestines
aren't able to break down
fructose efficiently. Fructose is a simple sugar,
known as a monosaccharide, that comes mostly
from fruit and some vegetables.

23. Due to enzyme insufficiency
 Lactose deficiency: Lactose intolerance is a
condition in which people have symptoms due to
the decreased ability to digest lactose, a sugar
found in dairy products. Those affected vary in the
amount of lactose they can tolerate before
symptoms develop. Symptoms may include
abdominal pain, bloating, diarrhea, gas, and
nausea.

25.  Sucrose intolerance
 Pancreatic insufficiency: Pancreatic
Insufficiency (EPI) is a condition which occurs
when the pancreas does not make enough of a
specific enzyme the body uses to digest food in
the small intestine. The pancreas is a glandular
organ. That means the pancreas secretes juices
that maintain the proper function of the body.

27.  Deficient or ineffective bile salts
 Intestinal disaccharides deficiency

28. Due to digestive failure
 Chronic pancreatitis
 Carcinoma of pancreas
 Zollinger-Ellison syndrome is a rare condition in
which one or more tumors form in pancreas or the
upper part of small intestine (duodenum). These
tumors, called gastrinomas, secrete large
amounts of the hormone gastrin, which causes
stomach to produce too much acid.

29.  Obstructive jaundice: jaundice resulting
from blockage of the bile ducts or abnormal
retention of bile in the liver.
 Bacterial overgrowth

30. Due to other systemic
disease affecting GI tract
 Hypothyroidism and hyperthyroidism
 Addison's disease, also known as primary adrenal
insufficiency and hypocortisolism, is a long-term
endocrine disorder in which the adrenal glands do
not produce enough steroid hormones. Symptoms
generally come on slowly and may include
abdominal pain, weakness, and weight loss.

32.  Diabetes mellitus (DM), commonly known
as diabetes, is a group of metabolic disorders
characterized by high blood sugar levels over a
prolonged period. Symptoms of high blood
sugar include frequent urination, increased
thirst, and increased hunger. If left
untreated, diabetes can cause many
complications.

33.  Mastocytosis is a condition that occurs when
mast cells accumulate in skin and/or internal
organs such as the liver, spleen, bone marrow,
and small intestines. The signs and symptoms
vary based on which part(s) of the body are
affected.

34.  Mast cells plays an important protective
role as well, being intimately involved in
wound healing, immune tolerance,
defense against pathogens.
 Mast cell is a immune system of vertebrae.
It gives imflammatory resonse.that give
response to produce heparine and
histamine.

35.  Amyloidosis : is a rare disease that occurs
when a substance called amyloid builds up in
your organs. Amyloid is an abnormal protein
that is produced in your bone marrow and
can be deposited in any tissue or organ.

36.  Carcinoid syndrome is a
paraneoplastic syndrome comprising the
signs and symptoms that occur secondary
to carcinoid tumors.

37.  Hypogammaglobulinemia is an immune
disorder characterized by a reduction in all
types of gamma globulins, including
antibodies that help fight infection. It may be
congenital (present at birth), related to
medication; it may be due to a kidney or
gastrointestinal condition, cancer or severe
burns.

38. DRUG INDUCED
 Laxative or antacids
 Neomycin
 cholestyramine

40. CLINICAL MANIFESTATIONS
 Many symptoms differ depending on the
specific nutrient or nutrients that aren’t being
absorbed properly. Other symptoms are a
result of a deficiency of that nutrient, which is
caused by its poor absorption.

41.  Fats. have light-colored, foul-smelling stools
that are soft and bulky. Stools are difficult to
flush and may float or stick to the sides of the
toilet bowl.
 Protein. have dry hair, hair loss, or fluid
retention. Fluid retention is also known
as edema and will manifest as swelling.

42.  Certain sugars. have bloating, gas,
or explosive diarrhea.
 Certainvitamins. have anemia, malnutrition,
low blood pressure, weight loss, or muscle
wasting.

43.  Malabsorption may affect people based on
age or gender. women may stop
menstruating, and children may not grow
properly. Their weight or rate of weight gain
may be significantly below that of other
children of a similar age and gender.

44. DIAGNOSTIC EVALUATION
 BLOOD TEST: These tests measure the level of
specific nutrients in blood, such as vitamin B-
12, vitamin D, folate, iron, calcium,
carotene, phosphorus, albumin, and protein.
 A lack of one of these nutrients may not necessarily
mean have malabsorption syndrome. It can mean
you’re not choosing foods with healthy levels of
nutrients. Normal levels of these nutrients suggest
that malabsorption is not the problem.

45.  STOOL TEST: Stool tests can measure fat in
samples of stool, or feces. These tests are the
most reliable because fat is usually present in
the stool of someone with malabsorption
syndrome.

46.  RADIOLOGY TEST : Imaging tests, which
take pictures of digestive system, may be
done to look for structural problems. For
instance, doctor could request a CT scan to
look for thickening of the wall of small
intestine, which could be a sign of Crohn’s
disease.

47.  Breath tests can be used to test for lactose
intolerance.
 If lactose isn’t being absorbed, it enters the colon.
Bacteria in the colon break down the lactose and
produce hydrogen gas. The excess hydrogen is
absorbed from intestine, into bloodstream, and then
into lungs. then exhale the gas.
 If have hydrogen gas in breath after ingesting a
product containing lactose, may have lactose
intolerance.

48.  A biopsy will likely be done using an endoscopy. A
tube is inserted into mouth and sent through
esophagus and stomach and into small intestine
to take a small sample of cells.

49. MANGEMENT
 Treatment depends on cause and may include
a special diet, medication to replace intestinal
enzymes or reduce spasms, and vitamin or
mineral supplements, such as B12 and iron.

50. 1. Replacements of nutrients, electrolytes and
fluid may be necessary. In severe deficiency,
hospital admission may be required for
parentral administration. Surgery may need
long term total parentral nutrition. Pancreatic
enzymes are supplemented orally in
insufficiency.

51. 2. Bacterial overgrowth usually respond well of
course of antibiotics. Use of cholestyremine to
bind bile acid will help reducing diarrhea in bile
acid malabsorption.

52. 3. Dietary modification is important in some
conditions. Life-long avoidance of particular
food or food constituent may be needed in
celiac disease.