SB Disease - Malabsorption/Malnutrition Flashcards
What is the difference between malabsorption and maldigestion?
Maldigestion = Impaired breakdown of nutrients to absorbale products
Malabsorption = Defective mucosal uptake and transport of adequately digested nutrients including vitamins and trace elements.
Know the 4 major causes for maldigestion and the 5 for malabsorption?
Maldigestion: Gastric dysmotility, pancreatic insufficiency, bile salt deficiency and poor mucosal defense (pathogens)
Malabsorption: Decreased intestinal surface area, decreased circulation/lymphatic drainage, mucosal infiltration with abnormal cells (lymphoma, RT), transport protein mutations and impaired motility
What 2 tests are helpful in diagnosing malabsorption?
Quantitative fecal fat, SB biopsy, d-xylose breath test
What is SBBOG syndrome, how is it diagnosed and medically treated?
Small bowel bacterial overgrowth;
C14Xylose Breath test and aspiration of fluids
What are the diagnostic tests for confirming Celiac Sprue and pancreatic insufficiency (gold standard – same as chronic pancreatitis)?
Celiac sprue = SB biopsy, TTG, Anti-endomesial Ab
Pancreatic insufficiency = Secretin stimulation test/measurement of pancreatic enzymes in the blood (trypsinogen/trypsin) or in the stool (elastase/chymotrypsin)
Pancreatic ductal obstructive problems = ERCP
How are Celiac Sprue and pancreatic insufficiency managed?
- Gluten-free diet = Celiac Sprue
- PI = pancreatic enzymes
What is the Schilling test and associated stages used to determine?
The Schilling test is used to determine causes for Vitamin B12 (cobalamin) malabsorption – with rule-outs of pernicious anemia, SBBOG, BB mucosal disease, PI.
What is celiac disease?
An autoimmune disorder seen in 1% of population which damages the lining of the small intestine and prevents it from absorbing parts of food that are important for staying healthy.
The damage is due to a reaction to eating gluten, which is found in wheat, barley, rye, and possibly oats.
What may be protective with celiac disease?
Breastfeeding maybe protective
What causes celiac disease?
Precipitated by ingestion of gluten (Found in wheat, barley, rye)
Inflammatory reaction in upper small intestine
How does a patient present with celiac disease?
Diarrhea, abdominal pain
How do we diagnose celiac disease?
- Duodenal biopsy
- Endomysial IgA antibodies
- Response to gluten free diet
How do we treat celiac disease?
- Gluten free diet
What are complications of celiac disease?
Iron deficiency, osteoporosis
