MalabsorptionMalabsorption

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CONDITIONS OF MALABSORPTIONCONDITIONS OF MALABSORPTION

Malabsorption: is the inability of the digestive system to absorb one or more of

•The major vitamins( B12)•Minerals (iron& calcium)

•Nutrients (carbohydrates,fats& proteins).

Interruptions in the complex digestive process may occur anywhere in the digestive system and cause decreased

absorption.

Diseases of the small intestine are the most commoncause of malabsorption.

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The conditions that cause malabsorption can be grouped into the following categories:

Mucosal disorders; causing generalized malabsorption (celiacsprue, regional enteritis, radiation enteritis).

Infectious diseases causing generalized malabsorption (small bowel bacterial overgrowth)

Luminal problems causing malabsorption(pancreatic insufficiency)

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PathophysiologyPathophysiology

•Postoperative malabsorption ( gastricorintestinal resection).

•Disorders that cause malabsorption of specific nutrients

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The hallmarks are diarrhea or frequent, loose, bulky, foul smelling stools that have increased fat content &are often grayish.

Abdominal distention, pain, increased flatus, weakness, weight loss, &a decreased sense of well-being.

The chief result of malabsorption is malnutrition, manifested by weight loss and other signs of vitamin and mineral deficiency (eg, easy bruising, osteoporosis, anemia).

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Patients with a malabsorption syndrome,if untreated, become weak & emaciated because of starvation & dehydration

Failure to absorb the fat-soluble vitamins A, D,and K causesa

corresponding avitaminosis.

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Stool for quantitative &qualitative fat analysis. Lactose tolerance tests , D-xylose absorption tests Endoscopy with biopsy of the mucosa is the best diagnostic Biopsy of the small intestine is performed to assay enzyme

activityor to identify infection or destruction of mucosa. Ultrasound studies, CT scans, & x-ray findings can reveal

pancreatic or intestinal tumors that may be the cause. A complete blood cellcount is used to detect anemia Pancreatic function tests can assist in the diagnosis of specific

disorders.

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Intervention is aimed at avoiding dietary substances that aggravate malabsorption & at supplementing nutrients that have been lost.

Common supplements are water-soluble vitamins(eg, B12, folic acid), fat-soluble vitamins (ie, A, D, and K), &minerals (eg,calcium, iron).

Dietary therapy is aimed at reducing gluten intake in patients with celiac sprue.

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Folic acid supplements are prescribed for patients with tropical sprue

Antibiotics(eg, tetracycline, ampicillin) are sometimes needed in the treatment of tropical sprue & bacterial overgrowth syndromes.

Antidiarrheal agents may be used to decrease intestinal spasms.

Parenteral fluids may be necessary to treat dehydration.

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The nurse provides patient & family education regarding diet& the use of nutritional supplements (Chart 38-2).

It is important to monitor patients with diarrhea for fluid & electrolyte imbalances.

Patient education includes information about the risk of osteoporosis related to malabsorption of calcium

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