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Malabsorption is a digestive disorder where your small intestine cannot properly absorb the nutrients, vitamins, and minerals from the food you eat into your bloodstream, potentially leading to nutritional deficiencies and various health complications.
Your small intestine plays a crucial role in absorbing essential nutrients from the food you eat. When you have malabsorption, your small intestine cannot properly take in nutrients from food into your bloodstream. This can affect your ability to absorb one or more types of nutrients, including proteins, fats, carbohydrates, vitamins, and minerals.
The process of digestion can be thought of as having three parts. The first part breaks down food into digestible pieces. The second part absorbs all the nutrients from your food. The third part eliminates the waste that is left over. Malabsorption disorders affect the second stage of this process.
Although malabsorption and maldigestion (impaired breakdown of food) differ, digestion and absorption are interdependent, and the term "malabsorption" often refers to problems in either process.
Malabsorption can result from problems in two main areas: food not being digested properly, or your intestines not being able to absorb nutrients.
Several medical conditions can interfere with normal nutrient absorption. Infections from bacteria, viruses, or parasites can damage your intestinal wall so that digested substances cannot get through. You then lose those nutrients through your stool.
Common causes of malabsorption include:
Your pancreas produces enzymes that help absorb fats and other nutrients. A decrease in these enzymes makes it harder to absorb fats and certain nutrients. Problems with your pancreas may be caused by trauma, infection, swelling, or surgery to remove part of the organ.
Some gastrointestinal diseases cause general malabsorption of all kinds of nutrients. In other cases, you may have particular difficulties absorbing a specific kind of nutrient.
Some people are sensitive to one or several carbohydrates (sugars). You may experience this primarily as gas pain and abdominal bloating. Carbohydrates that are not fully absorbed in your small intestine get fermented by bacteria in your colon. The bacteria break them down into gases and short-chain fatty acids. The gases cause intestinal gas, and the short-chain fatty acids cause fatty stools.
This is a common type of malabsorption. Fats that are not absorbed in your small intestine pass to your colon, causing fatty stools (steatorrhea). Fatty stools are greasy and runny and particularly smelly. They may be light-colored and float. Fat malabsorption also leads to the malabsorption of fat-soluble vitamins (A, D, E and K).
Sometimes fat malabsorption results from a lack of bile from diseases of the gallbladder, bile ducts, or liver. Leftover bile salts trigger your colon to secrete water, causing chronic diarrhea.
Protein malabsorption does not usually occur by itself unless you have a particular intolerance, such as milk protein intolerances or gluten intolerance.
The most common symptom of malabsorption is chronic diarrhea. You will have lots of loose, oily stools that smell worse than usual.
Other symptoms may include:
Whatever you cannot absorb will pass undigested in your stools. People with malabsorption syndrome often have diarrhea as a side effect, which can make malabsorption worse. With diarrhea, food moves too fast through your bowels for nutrients to be absorbed.
In children, malabsorption can cause weight loss or poor weight gain, often called failure to thrive. The child may not grow and develop normally. Adults may also have failure to thrive, with weight loss, muscle wasting, weakness, and even problems thinking.
Vitamin and mineral deficiencies can cause additional symptoms, including:
If your body is not getting the vitamins, minerals, and other nutrients it needs to stay strong and thrive, you could have serious complications.
Over time, your body will start to show signs of deficiency in those nutrients that you cannot absorb. Deficiencies in any of the macronutrients (protein, fats, or carbohydrates) will cause signs of undernutrition, such as muscle wasting and reduced immunity. Deficiencies in micronutrients (vitamins and minerals) may affect your eyes, bones, skin, and hair.
When it is not treated, malabsorption syndrome might lead to:
Certain nutrients, such as vitamin A and zinc, are vital for a healthy immune system and proper growth. If your body is not absorbing these and other important vitamins and minerals, your health can suffer.
Long-term malabsorption can also result in anemia, gallstones, kidney stones, and thin and weakened bones.
Doctors usually perform stool tests to look for unabsorbed fat and blood tests to check for vitamin and mineral deficiencies.
If these tests show malabsorption, doctors then do tests to look for the cause. They may:
Additional tests your doctor may use include:
Treatment depends on the cause of malabsorption. Two basic principles underlie management: correcting nutritional deficiencies and, when possible, treating the underlying disease causing the problem.
Caloric and protein replacement is essential. It is crucial to supplement with various minerals, such as calcium, magnesium, iron, and vitamins, which may be deficient in malabsorption.
If you have trouble with only certain foods, doctors will have you avoid them. If you are missing certain digestive enzymes, sometimes you can take enzyme supplements. If you have a vitamin deficiency, you will take extra vitamins.
Treatment may include:
In severe intestinal disease, such as extensive regional enteritis and following a massive resection, intravenous nutrition may become necessary.
Some malabsorption diseases have specific treatments:
This guide is here to help you understand the condition. It does not replace a conversation with your doctor, who knows your situation best.
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