Malabsorption Flashcards
Definition of malabsorption?
Defective mucosal absorption caused by:
Defective luminal digestion
Mucosal disease
Structural disorders
5 common causes of malabsorption?
Coeliac disease Crohn's disease Post-infectious malabsorption Biliary obstruction Cirrhosis
5 uncommon causes of malabsorption?
Pancreatic cancer Parasites Bacterial overgrowth Drugs Short bowel syndrome (inc. due to resections)
What is hartsnup disease?
Dysfunction of neutral amino acid uptake; defect in system B0AT1
What is cystinuria?
Dysfunction of cationic amino acid uptake; defect in system b0+AT
Symptoms of coeliac disease?
Weight loss (nutritional deficiencies)
Diarrhoea
Excess flatus
Abdominal discomfort
Cause and symptoms of lactose malabsorption?
Deficiency of lactase: History of diarrhoea induction Abdominal discomfort Flatulence ....all following ingestion of dairy products
Diagnosis of lactose malabsorption?
Lactose breath hydrogen test
Alternative: oral lactose intolerance test
What is tropical sprue?
Colonisation of the intestine by an infectious agent OR alterations in the intestinal bacterial flora, induced by exposure to an environmental agent
Symptoms of tropical sprue?
Diarrhoea Steatorrhea Weight loss Nausea and anorexia Anaemia
Diagnosis of tropical sprue?
Biopsy
Treatment of tropical sprue?
Tetracycline + folic acid
What is Whipple’s disease?
Rare disease assoc. with GI malabsorption that is caused by Tropheryma whipplei; it is a multi-system disorder that is assoc. with HLA-B27
Symptoms of Whipple’s disease?
Weight loss Diarrhoea and steatorrhea Abdominal distension Fever Arthritis Nutritional deficiency symptoms
Diagnosis of Whipple’s disease?
Demonstration of T. whipplei in the involved tissues, using microscopy
Treatment of Whipple’s disease?
Antibiotics
How can Crohn’s disease cause malabsorption?
Patients can have extensive ileal involvement, extensive intestinal resections, enterocolic fistulas and strictures; this can lead to small intestinal bacteria overgrowth. They may also develop significant malabsorption
Symptoms of Crohn’s disease?
Abdominal pain and diarrhoea Fever and weight loss Abdominal tenderness (often in RLQ)
Diagnosis of Crohn’s disease?
Endoscopy
Barium imaging of small bowel mucosal disease, inc. strictures, ulcerations, fistulas
CT/MRI scan
Treatment of Crohn’s disease?
Steroids and immunosuppressants
Azathioprine 6-MP
Anti-TNF therapy
Risk factors for infection with Giardia Lamblia?
Travel to areas where the water supply may be contaminated, swimming in ponds, etc
Symptoms of Giardia infection?
Diarrhoea and flatulence
Abdominal cramps and epigastric pain
Malabsorption syndrome with steatorrhea; weight loss
Diagnosis of Giardia lamblia?
Stool examination for ova and parasites (three separate stool samples)
Treatment of Giardia lamblia infection?
Metronidazole (oral)
Symptoms of small bowel bacterial overgrowth?
Diarrhoea, steatorrhea and macrocytic anaemia (B12), E. coli or Bacteroides
Diagnosis of small bowel bacterial overgrowth?
Low cobalamin and high folate levels
Best established by a Schilling test (for pernicious anaemia)
Treatment of small bowel bacterial overgrowth?
Surgical correction of an anatomical blind loop
Tetracycline
GI symptoms of malabsorption?
Diarrhoea (duration, steattorhea - floaters - offensive)
Easy bruising
Vitamin C scurvy
Vitamin K deficiency
What is acrodermatitis enteropathica and symptoms?
Autosomal recessive disorder affecting zinc uptake
Symptoms:
Peri-oral rash
Alopecia
Acral (skin cancer)
What is dermatitis herperiformis and symptoms?
Assoc. with HLA-B8 and may indicate coeliac disease
Symptoms:
Itchy blisters on extensor surfaces (e.g: elbows)
Signs - sub-epithelial IgA deposition
Causes of glossitis and angular stomatitis?
Vitamin B/Iron deficiency
Causes of koilonychia?
Iron deficiency
