5- malabsorption Flashcards
what is malabsorption?
defective mucosal absorption caused by (defective luminal digestion, mucosal disease, structural disorders)
what are common causes of malabsorption?
- coeliac disease
- crohn’s disease
- post infection
- biliary obstruction
- cirrhosis
what can some sort of biliary obstruction cause malabsorption of?
fat malabsorption as fat are made to micelles with bile acids
when can you get lactate deficiency?
common in gastroenteritis -
why can coeliac cause malabsorption?
inflammatory damage in villi so can’t absorb
why can tropical sprue cause malabsorption?
damage at brush border, present with fat malabsorption (steatorrhea presentation)
what deficiency is common for b12 malabsorption?
crohn’s disease
what parasitic infections can cause what malabsorption?
like giardia, can mimic coeliac well - steatorrhea presentation
what parts of past medical history is important to notice for malabsorption?
- gastric or small bowel resection
- GI diversion (bariatric)
- radiation exposure
- travel
what malabsorption is associated with steatorrhea?
fats
what malabsorption is associated with scurvy?
vitamin C deficiency
what malabsorption is associated with easily bruising?
vitamin K deficiency
what malabsorption is associated with peri-oral scaly rash?
impaired zinc update
what condition is associated with dermatitis herpetiformis rash?
rash associated with coeliac = very itchy with blisters
what malabsorption is associated with koilonychia?
iron deficiency
what malabsorption is associated with stomatitis?
vitamin b or iron deficiency
what baseline investigations can be done for malabsorption?
- full blood count →would show anaemia
- coagulation
- LFTs (low PT = vit K deficiency)
- albumin
- calcium/magnesium
- stool culture
what anatomic investigations can be done for malabsorption?
- endoscopy →useful but obviously less comfortable for patients
- imaging - CT (for pancreas), MRI (bowel)
what is management for malabsorption?
replace deficiency & support nutritionally
