Definition

Malabsorption is when the body has trouble absorbing certain vitamins, minerals, carbohydrates, proteins, or fats from food even when someone is eating properly.

The Intestines

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Causes

During normal digestion, the liver creates a fluid called bile that helps break down food in the intestines. The pancreas also creates an enzyme that helps break food down into usable nutrients. The freed nutrients can then pass through the walls of the intestine and into the bloodstream. Malabsorption may be caused by a problem with any of these digestive steps such as:

    
  • Inflammation and irritation of the intestines can makes it difficult for the intestines to properly absorb nutrients. Inflammation may be caused by a number of conditions such as:     
  • Lactose intolerance
  • Celiac disease
  • Intestinal parasites, such as giardiasis—malabsorption should pass once infection has cleared
  • Infections such as Whipple disease
  • Crohn disease
  • Decrease or loss of digestive fluids and enzymes because of:    
  • Pancreas dysfunction which may occur with cystic fibrosis, pancreatitis, or pancreatic cancer
  • Liver injury or illness that can decrease bile production
  • Bacterial overgrowth syndrome
  • Improper breakdown of food in stomach or quick dumping from stomach
  • Surgical removal of part of the intestine (short bowel syndrome) or stomach—less surface area and time to absorb nutrients
  • Abnormal movement of bowel muscles which can be caused by systemic conditions like hypo/hyperthyroidism and diabetes
  • 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.