GI Malabsorption Flashcards
Common causes in UK
Coeliac disease
Chronic pancreatitis
Crohn’s disease
Other causes
Low bile Pancreatic insufficiency Small bowel mucosa Bacterial overgrowth Infection Intestinal hurry
Causes of low bile and thus GI malabsorption
Primary biliary cholangitis
Ileal resection
Biliary obstruction
Colestyramine
Causes of pancreatic insufficiency and thus GI malaborption
Pancreatic cancer
Cystic fibrosis
Causes of small bowel mucosa and thus GI malabsorption
Whipples disease Enteritis Tropical sprue Small bowel resection Brush border enzyme deficiencies e.g. lactase insufficiency Drugs Amyloid
What drugs can cause small bowel mucosa
Metformin
Neomycin
Alcohol
Causes of bacterial overgrowth and thus GI malabsorption
Spontaneous (elderly)
Jejunal diverticula
Post-op blind loops
DM and PPI are risk factors
Infections that result in GI malabsorption
Giardiasis
Diphyllobothriasis (B12 malabsorption)
Strongyloidiasis
Causes of intestinal hurry and thus GI malabsorption
Post-gastrectomy dumping
Post-vagotomy
Gastrojejunostomy
Symptoms
Diarrhoea Decreased weight Lethargy Steatorrhoea Bloating
Deficiency signs
Anaemia (low Fe, B12, folate) Bleeding disorders (low vit K) Oedema (low protein) Metabolic bone disease (low vit D) Neurological features e.g. neuropathy
Tests
Coeliac tests FBC (low or high MCV) Low: Ca2+; Fe; B12 + folate High INR Lipid profile Stool Breath hydrogen analysis (for bacterial overgrowth) Endoscopy + Small bowel biopsy
Test of stool
Sudan stain for fat globules, stool microscopy (infestation) - elastase
Presentation in general of malabsorption
Weight loss
Steatorrhoea
Anaemia
