malabsorption: intro, coeliac disease, lactose intolerance, tropical sprue and wihpples Flashcards
malabsorption is Defective mucosal absorption caused by:
three things
- Defective luminal digestion
- Mucosal disease
- Structural disorders
what are the diseases which commonly cause malabsorption? 6
- coeliac
- crohn’s disease
- post infectious
- biliary obstruction
- cirrhosis
- chronic pancreatitis
what are the diseases which uncommonly cause malabsorption? 5
- pancreatic cancer
- parasites
- bacterial overgrowth
- drugs
- short bowel
___ ___This is a T-cell- mediated autoimmune disease of the small bowel where prolamin (gliadin from wheat, hordeins from barley or secalins from rye) intolerance causes villous atrophy and malabsorption (including of bile acids)
This is a T-cell- mediated autoimmune disease of the small bowel where prolamin (gliadin from wheat, hordeins from barley or secalins from rye) intolerance causes vilous atrophy and malabsorption (including of bile acids)
in coeliac disease Intestinal antigen-presenting cells in people expressing HLA -____ or HLA-___ bind with dietary ____ peptides in their antigen binding grooves and activate specific mucosal _ ______ which produce _____ causing _____ damage
Intestinal antigen-presenting cells in people expressing HLA -DQ2 or HLA-DQ8 bind with dietary gluten peptides in their antigen binding grooves and activate specific mucosal T lymphocytes which produce cytokines causing mucosal damage
what are the symptoms of coeliac disease? 9
- Spectrum from assymptomatic to - nutritional deficiencies
- Weight loss
- Stinking stools / steatorrhoea
- Diarrhoea
- Abdo pain and bloating
- Nausea and vomiting
- Excess flatus
how is a diagnosis of coeliac disease made? 3
IgA anti-tissue transglutaminase test (tTGA)
biopsy confirmative - do in duodenum
anti-gliadin , anti-TTG and anti-endomesial antibodies
for the diagnosis of coeliac disease where is the biopsy done?
in the duodenum
which antibodies are present in coeliac disease to help with diagnosis? 3
anti-gliadin , anti-TTG and anti-endomesial antibodies
what is the treatment of coeliac disease?
gluten free diet
what are the complications of coeliac disease?5
- Anaemia
- Secondary lactose intolerance
- T-cell lymphoma
- Increased risk of malignancy
- Myopathies, neuropathies, hyposplenism
in lactose malabsorption there is a deficiency in ____
lactase
what is the presentation of someone with lactose malabsorption? 3
History of the induction of diarrhoea, abdominal discomfort and flatulence following ingestion of dairy products
how is lactose intolerance diagnosed? 2
- Confirmed by the lactose breath hydrogen test
- Oral lactose intolerance test
____ ___ is Vilous atrophy and malabsorption occurring in the far and middle east and caribbean. It is colonisation of the intestine by an___ ___ or alterations in the intestinal bacterial flow by the exposure to another environmental agent
tropical sprue, infectious agent
