IBD & Malapsorption Flashcards
Which enzymes digest carbs
- salivary amylase
- pancreatic amylase
- small intestine maltase
- small intestine lactase
Which enzymes digest proteins
- gastric pepsin
- pancreatic trypsin
- small intestine peptidases
Which enzymes digest nucleic acids
- pancreatic nuclease
- small intestine nucleosidases
Which enzyme digests fat
- pancreatic lipase
Describe malabsorption
broad spectrum; associated with diminished intestinal absorption of one or more dietary nutrients
Describe the 3 steps of nutrient absorption
- luminal processing (breakdown)
- absorption into intestinal mucosa
- transport into circulation
Describe global vs partial/isolated malabsorption
Describe some causes & clinical manifestations of global malabsorption
Causes
- diffuse mucosal involvement
- reduced absorptive area
Manifestations
- steatorrhea
- weight loss
Describe fat absorption
- normally +94% absorbed
- starts in upper GI with emulsification
- majority absorbed by pancreatic lipase & colipase
- influenced by type of dietary lipid & presence of other nutrients
Describe the presentation and lab findings for fat malabsorption
presentation
- steatorrhea
- diarrhea without flatulence
- pale & voluminous
Labs
- >6% fractional fat excretion
Describe carb absorption & malabsorption
- only absorbed in small intestine
- lactose malabsorption only clinically important disorder of carb absorption
- deficiency in pancreatic amylase, reduced disaccharidase activity & decreased intestinal surface area
Describe the differences between primary & secondary carb malabsorption
Describe the presentation of carb malnutrition
Describe protein absorption
- begins in stomach with gastric pepsin (depends on other dietary constituents, gastric motility, pH)
- remainder absorbed in small intestine
Describe a few causes of protein malabsorption
- Impaired pancreatic protease: chronic pancreatitis, CF
- Generalized reduction of intestinal surface area: hypoalbuminemia, protein malnutrition, kwashiorkor
Describe the presentation and lab findings of protein malnutrition
Vitamin/mineral/trace element malabsorption results in a deficiency in the following…
- calcium
- magnesium
- vit B12
- iron
(MC seen in bariatric surgery population)
Describe the etiology of IBD
Describe the etiology of Crohn’s disease
Describe the etiology of ulcerative colitis
Describe the presentation of crohn’s disease
Describe the presentation of ulcerative colitis
describe the diagnosis of crohn’s
describe the diagnosis of ulcerative colitis
Describe the treatment of IBD
