Malabsorption, Coeliac disease and tropical sprue Flashcards
Common causes of malabsorption in the UK?
Coeliac disease
Chronic pancreatitis
Crohns disease
Rarer causes of malabsorption in UK
Decreased bile Pancreatic insufficiency Small bowel mucosa deficiencies Infection/ bacterial overgrowth Intestinal hurry
What are causes of decreased bile secretion?
Biliary cirrhosis,
Biliary obstruction,
Surgical removal of ileum (where bile is reabsorbed) , cholestyramine (medication that removes bile)
What are common causes of pancreatic insufficiency?
CF and pancreatic cancer
What are causes of small bowel mucosa deficiencies?
Whipples disease Radiation enteritis Tropical sprue Small bowel resection Brush border enzyme deficiencies (lactase) Drugs: metformin, neomycin, alcohol Amyloid
What infections can cause malabsorption?
Bacterial overgrowth
Giardiasis (parasitic),
Diphyllobothriasis (B12 malabsorption)
Strongyloidiasis (helminth)
Clinical symptoms of malabsorption?
Diarrhoea Weight loss Steatorrhea Lethargy Bloating
What deficiency may cause anaemia?
Iron, B12 or folate
What deficiency may cause a bleeding disorder?
Vitamin K
fat soluble
What deficiency may cause oedema?
Decreased protein (albumin- leading to low oncotic pressure)
What deficiency may cause metabolic bone disease?
Vitamin D
What tests should be performed to find the cause of malabsorption?
Bloods Stool sample Barium swallow Breath hydrogen analysis (test for bacteria) Endoscopy
What blood test results are significant in malabsorption?
MCV- low in iron deficiency, high in folate or B12 deficiency
Low calcium, low iron, low B12 and folate
Raised INR and lipid profile
Coeliac test (looking for antibodies to gluten)
What findings may be significant in stool sample?
Sudan’s stain for fat globules
Stool microscopy for:
Alpha 1 antitrypsin (high levels suggests protein loss)
Elastase (low levels suggest pancreas insufficiency)
What causes is barium swallow used to test for in malabsorption?
Diverticula,
Crohn’s,
Radiation enteritis
