Malabsorption
Malabsorption involves problems with the body's ability to take in (absorb) nutrients from food.
Causes
Many diseases can cause malabsorption. Most often, malabsorption involves problems absorbing certain sugars, fats, proteins, or vitamins. It can also involve an overall problem with absorbing food.
Problems or damage to the small intestine that may lead to problems absorbing important nutrients. These include:
-
Celiac disease
Celiac disease
Celiac disease is an autoimmune condition that damages the lining of the small intestine. This damage comes from a reaction to eating gluten. This ...
Read Article Now Book Mark Article - Tropical sprue
-
Crohn disease
Crohn disease
Crohn disease is a disease where parts of the digestive tract become inflamed. It most often involves the lower end of the small intestine and the be...
Read Article Now Book Mark Article - Whipple disease
- Damage from radiation treatments
Radiation
Radiation therapy uses high-powered radiation (such as x-rays or gamma rays), particles, or radioactive seeds to kill cancer cells.
Read Article Now Book Mark Article -
Overgrowth of bacteria in the small bowel
Overgrowth of bacteria in the small bow...
Small bowel bacterial overgrowth is a condition in which very large numbers of bacteria grow in the small intestine.
Read Article Now Book Mark Article - Parasite or tapeworm infection
- Surgery that removes all or part of the small intestine
Enzymes produced by the pancreas help absorb fats and other nutrients. A decrease of these enzymes makes it harder to absorb fats and certain nutrients. Problems with the pancreas may be caused by:
- Cystic fibrosis
-
Infections or swelling of the pancreas
Infections or swelling of the pancreas
Pancreatitis is swelling of the pancreas. Chronic pancreatitis is present when this problem does not heal or recurs and does not improve, gets worse...
Read Article Now Book Mark Article - Trauma to the pancreas
- Surgery to remove part of the pancreas
Some of the other causes of malabsorption include:
-
AIDS and HIV
AIDS
Human immunodeficiency virus (HIV) is the virus that causes acquired immunodeficiency syndrome (AIDS). When a person becomes infected with HIV, the ...
Read Article Now Book Mark Article - Certain medicines (tetracycline, some antacids, some medicines used to treat obesity, colchicine, acarbose, phenytoin, cholestyramine)
-
Gastrectomy and surgical treatments for obesity
Gastrectomy
Gastrectomy is surgery to remove part or all of the stomach. If only part of the stomach is removed, it is called partial gastrectomyIf the whole sto...
Read Article Now Book Mark ArticleSurgical treatments for obesity
Gastric bypass is surgery that helps you lose weight by changing how your stomach and small intestine handle the food you eat. After the surgery, you...
Read Article Now Book Mark Article -
Cholestasis
Cholestasis
Cholestasis is any condition in which the flow of bile from the liver is slowed or blocked.
Read Article Now Book Mark Article - Chronic liver disease
-
Cow's milk protein intolerance
Cow's milk protein intolerance
Lactose is a type of sugar found in milk and other dairy products. An enzyme called lactase is needed by the body to digest lactose. Lactose intoler...
Read Article Now Book Mark Article - Soy milk protein intolerance
Symptoms
In children, current weight or rate of weight gain is often much lower than that of other children of similar age and sex. This is called failure to thrive. The child may not grow and develop normally.
Failure to thrive
Failure to thrive refers to children whose current weight or rate of weight gain is much lower than that of other children of similar age and sex....
Read Article Now Book Mark ArticleAdults may also have failure to thrive, with weight loss, muscle wasting, weakness, and even problems thinking.
Changes in the stools are often present, but not always.
Changes in the stools may include:
- Bloating, cramping, and gas
- Bulky stools
- Chronic diarrhea
- Fatty stools (steatorrhea)
Exams and Tests
Your health care provider will do an exam. Tests that may be done include:
- Blood and urine tests
- CT scan of the abdomen
-
Hydrogen breath test
Hydrogen breath test
Lactose tolerance tests measure the ability of your intestines to break down a type of sugar called lactose. This sugar is found in milk and other d...
Read Article Now Book Mark Article - MR or CT enterography
-
Schilling test for vitamin B12 deficiency
Schilling test
The Schilling test can determine whether the body absorbs vitamin B12 normally. It helps assess the cause of vitamin B12 deficiency. This test is r...
Read Article Now Book Mark Article -
Secretin stimulation test
Secretin stimulation test
The secretin stimulation test measures the ability of the pancreas to respond to a hormone called secretin. The small intestine produces secretin wh...
Read Article Now Book Mark Article -
Small bowel biopsy
Small bowel biopsy
Enteroscopy is a procedure used to examine the small intestine (small bowel).
Read Article Now Book Mark Article -
Stool culture or culture of small intestine aspirate
Stool culture
A fecal culture is a lab test to find organisms in the stool (feces) that can cause gastrointestinal symptoms and disease.
Read Article Now Book Mark ArticleCulture of small intestine aspirate
Small intestine aspirate and culture is a lab test to check for infection in the small intestine.
Read Article Now Book Mark Article -
Stool fat testing
Stool fat testing
The fecal fat test measures the amount of fat in the stool. This can help gauge the percentage of dietary fat that the body does not absorb....
Read Article Now Book Mark Article - X-rays of the small bowel or other imaging tests
Treatment
Treatment depends on the cause and is aimed at relieving symptoms and ensuring the body receives enough nutrients.
A high-calorie diet may be tried. It should supply:
- Key vitamins and minerals, such as iron, folic acid, and vitamin B12
Iron
Iron is a mineral found in every cell of the body. Iron is considered an essential mineral because it is needed to make hemoglobin, a part of blood ...
Read Article Now Book Mark ArticleVitamin B12
Vitamin B12 is a water-soluble vitamin. Water-soluble vitamins dissolve in water. After the body uses what it needs of these vitamins, leftover amo...
Read Article Now Book Mark Article - Enough carbohydrates, proteins, and fats
If needed, injections of some vitamins and minerals or special growth factors will be given. Those with damage to the pancreas may need to take pancreatic enzymes. Your provider will prescribe these if necessary.
Medicines to slow down the normal movement of the intestine can be tried. This may allow food to remain in the intestine longer.
If the body is not able to absorb enough nutrients, total parenteral nutrition (TPN) is tried. It will help you or your child get nutrition from a special formula through a vein in the body. Your provider will select the right amount of calories and TPN solution. Sometimes, you can also eat and drink while getting nutrition from TPN.
Total parenteral nutrition (TPN)
Total parenteral nutrition (TPN) is a method of feeding that bypasses the gastrointestinal tract. A special formula given through a vein provides mo...
Read Article Now Book Mark ArticleOutlook (Prognosis)
The outlook depends on what is causing the malabsorption.
Possible Complications
Long-term malabsorption can result in:
-
Anemia
Anemia
Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. There are man...
Read Article Now Book Mark Article -
Gallstones
Gallstones
Gallstones are hard deposits that form inside the gallbladder. These may be as small as a grain of sand or as large as a golf ball.
Read Article Now Book Mark Article -
Kidney stones
Kidney stones
A kidney stone is a solid mass made up of tiny crystals. One or more stones can be in the kidney or ureter at the same time.
Read Article Now Book Mark Article -
Thin and weakened bones
Thin and weakened bones
Osteoporosis is a disease in which bones become fragile and more likely to break (fracture).
Read Article Now Book Mark Article
When to Contact a Medical Professional
Contact your provider if you have symptoms of malabsorption.
Prevention
Prevention depends on the condition causing malabsorption.
References
Högenauer C, Hammer HF. Maldigestion and malabsorption. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 104.
Semrad CE. Approach to the patient with diarrhea and malabsorption. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 131.
-
Digestive system - illustration
The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.
Digestive system
illustration
-
Cystic fibrosis - illustration
Cystic fibrosis is the most common cause of chronic lung disease in children and young adults, and the most common fatal hereditary disorder affecting white people in the United States.
Cystic fibrosis
illustration
-
Digestive system organs - illustration
The digestive system organs in the abdominal cavity include the liver, gallbladder, stomach, small intestine and large intestine.
Digestive system organs
illustration
-
Digestive system - illustration
The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.
Digestive system
illustration
-
Cystic fibrosis - illustration
Cystic fibrosis is the most common cause of chronic lung disease in children and young adults, and the most common fatal hereditary disorder affecting white people in the United States.
Cystic fibrosis
illustration
-
Digestive system organs - illustration
The digestive system organs in the abdominal cavity include the liver, gallbladder, stomach, small intestine and large intestine.
Digestive system organs
illustration
Review Date: 5/6/2022
Reviewed By: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.