Malabsorption syndrome and Coeliac disease Flashcards
Define malabsorption
Failure of GI tract to absorb one or more nutrients causing weight loss or nutritional deficiencies
List 4 key clinical features of malabsorption
- Abdominal bloating
- Crampy abdominal pain
- Diarrhoea
- Steatorrhoea
- Weight loss
List 3 conditions affecting digestion which cause malabsorption
- Exocrine pancreatic insufficiency
- Disaccharidase deficiency
- Lactose intolerance
List 3 conditions causing pancreatic insufficiency
- Chronic pancreatitis
- Pancreatic cancer
- Cystic fibrosis
Treatment of pancreatic insufficiency?
Pancreatin - Creon
Lactase breaks down lactose into ______ and ______
What is the pathology of lactose intolerance?
Glucose and galactose
Deficiency in Lactase enzymes means lactose gets fermented by normal gut bacteria into gases (H2) - hence symptoms of bloating
Treatment of lactose intolerance
Dietary modifications: lactose free
List 4 conditions affecting absorption which cause malabsorption
- Cholecystectomy
- Crohn’s
- Amyloidosis
- Bile acid malabsorption
- Coeliac disease
List 4 infective causes affecting absorption which cause malabsorption
- Parasites: Giardiasis, worm infestation
- Tropical sprue
- Cholera
- Gastroenteritis: salmonella
- Small Intestine Bacterial Overgrowth (SIBO)
- C difficile
- Ileocolonic TB
- Whipple’s ds
What is Tropical sprue?
How do we treat it?
Rare GI disease resulting in malabsorption (unknown cause)
More prevalent in tropical countries so must ask about ‘travel history’
Treat with Antibiotics eg. tetracycline (check?)
List 3 risk factors for SIBO
poor gut motility due to
- strong pain killers
- elderly patients
- post surgical patients
What bacteria causes Whipple’s disease?
List 3 key clinical features of this condition
Tropheryma whipplei (+)
- Malabsorption: diarrhoea, weight loss
- Large-joint arthralgia
- Lymphadenopathy
What would a jejunal biopsy of Whipple’s disease show?
Foamy macrophages containing Periodic acid-Schiff (PAS) granules
List 4 Systemic diseases affecting GI tract which can cause malabsorption
- Diabetes
- Thyroid disorders (hyperthyroidism)
- Zollinger Ellison syndrome
- Carcinoid syndrome
- Cancer related: chemotherapy, advanced malignancies
How does Diabetes lead to Malabsorption?
- Autonomic neuropathy can cause diarrhea
- Metformin can cause diarrhea
What is Zollinger Ellison syndrome and how does it lead to malabsorption?
Gastrin secreting tumour of the pancreas
Excess gastrin → excess HCl → ulceration of mucosa → malabsorption