malabsorption Flashcards

1
Q

malabsorption

A
  • inadequate absorption of nutrients from the GI tract
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2
Q

macronutrients

A

carbohydrate, fat, protein

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3
Q

micronutrients

A

vitamins and minerals

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4
Q

mucosal (absorption)

A
  • issues relating directly to small intestine wall
  • crohn’s, coeliac, surgery
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5
Q

crohn’s disease / coeliac

A
  • mucosal
  • abnormal epithelium
  • deficient absorption
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6
Q

surgical resection / bypass / congenital abnormality

A
  • mucosal
  • short bowel
  • less surface area for absorption
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7
Q

cystic fibrosis / pancreatitis

A
  • pre-mucosal
  • lactase deficiency
  • insufficient digestive agents
  • macronutrients not broken down
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8
Q

small intestinal bacterial overgrowth

A
  • mucosal/pre-mucosal
  • damage to mucosa
  • bile salts metabolised by bacteria
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9
Q

crohn’s disease

A
  • malabsorption linked to inflammation
    deficiencies include:
  • iron deficiency (anaemia)
  • B12/folate deficiency
  • vitamin D/calcium deficiency
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10
Q

coeliac disease

A
  • autoimmune condition
  • gluten activates an abnormal mucosal response
  • chronic inflammation and damage to small intestine mucosa leading to villous atrophy (villi becoming inflamed)
  • fatigue, gastrointestinal symptoms, weight loss
  • common complications: anaemia, osteoporosis
  • treatment = elimination of gluten from diet
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11
Q

short bowel syndrome

A
  • usually secondary to surgery but can be congenital
  • may require parental nutrition
  • less surface area available for absorption
  • osteoporosis and vitamin deficiencies are potential risks
  • levothyroxine/warfarin/oral contraceptives/digoxin may need higher doses as small intestine site of absorption and less surface area means less absorption in bloodstream
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12
Q

chronic pancreatitis

A
  • chronic inflammation of pancreas leads to impaired function
  • affects more males than females
  • decrease in pancreatic enzymes
  • strong association with long term alcohol consumption
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13
Q

cystic fibrosis

A
  • inherited
  • decreased chloride secretion, increased sodium absorption = thick mucus
  • inhibits absorption
  • steatorrhea (too much fat in stools)
  • osteoporosis (weak bones)
  • malnutrition/weight loss
  • treated with pancreatic enzyme supplementation, fat soluble vitamin supplementation, calorie replacement
  • intestinal obstruction
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14
Q

lactase deficiency

A
  • primary, secondary, congenital or development
  • reduce or eliminate dietary lactose intake
  • alternative calcium source may be required
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15
Q

bacterial overgrowth

A
  • incidence increases with age
  • chronic pancreatitis and motility disorders most common causes
  • reduced gastric acid- restricts digestion/atrophic gastritis/ drugs
  • impaired motility - diabetes/ radiation enteritis, (post surgery loops)
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16
Q

fat malabsorption

A
  • problem with digestion (insufficient enzymes/bile) or absorption
  • malabsorption more common in coeliac, crohns
  • deficiencies of fat-soluble vitamins (A/D/E/K)
  • steatorrhea
17
Q

vitamin malabsorption

A
  • poor fat absorption will impact the absorption of vitamins A/D/E/K
  • vitamin D - osteoporosis
  • vitamin K - clotting problems
18
Q

treatment options for fat malabsorption

A
  • supplement of pancreatic enzymes: lipase, amylase, protease (creon)
  • treatment of cystic fibrosis/pancreatitis
  • cautions: local irritation, take during or just after a meal (timing is important)
  • derived from pork
19
Q

iron malabsorption

A
  • iron deficiency anaemia commonly seen with coeliac, crohn’s, small bowel resection
  • potential blood loss with crohn’s ulcerative colitis
  • oral iron replacement
20
Q

symptoms of fat malabsorption

A

steatorrhea - excess fat is lost in stools making them float appear pale and bulky and smell offensive

21
Q

symptoms of protein malabsorption

A
  • muscle wasting
  • malnutrition
  • oedema
22
Q

symptoms of carbohydrate malabsorption

A
  • bloating
  • flatulence
  • diarrhoea
23
Q

symptoms of vitamin e malabsorption

A

neurological problems

24
Q

symptoms of vitamin K malabsorption

A

coagulation (bleeding) problems

25
Q

symptoms of vitamin A malabsorption

A

night blindness