Malabsorption and Malnutrition

Question 1

3 Main symptoms of malabsorption

Answer 1

1. diarrhoea
2. steatorrhoea
3. weight loss

Question 2

3 main causes of malabsorption

Answer 2

1. intestinal (e.g. villous atrophy),
2. pancreatic (deficiency of pancreatic enzyme)
3. biliary (deficiency of bile-salts)

Question 3

Intestinal causes of malabsorption

Answer 3

• coeliac disease
• Crohn’s disease
• tropical sprue
• Whipple’s disease
• Giardiasis
• brush border enzyme deficiencies (e.g. lactase insufficiency)

Question 4

Pancreatic causes of malabsorption

Answer 4

• chronic pancreatitis
• cystic fibrosis
• pancreatic cancer

Question 5

Biliary causes of malabsorption

Answer 5

• biliary obstruction
• primary biliary cirrhosis

Question 6

Other causes of malabsorption that do not fall into the intestinal, pancreatic or biliary categories

Answer 6

• bacterial overgrowth (e.g. systemic sclerosis, diverticulae)
• short bowel syndrome
• lymphoma

Question 7

Definition of Malnutrition

Answer 7

1. BMI <18.5
2. unintentional weight loss >10% within 3-6 months
3. BMI <20 and unintentional weight loss >5% within the last 3-6 months

Question 8

What tool is used to screen for malnutrition?

Answer 8

MUST score

Question 9

Management of malnutrition

Answer 9

• dietician support
• ‘food-first’ approach (e.g. add full-fat cream), rather than just prescribing oral nutritional supplements
• take nutritional supplements between meals rather than instead of meals