Sunday, May 02, 2010

Finals Post 2 - Malabsorption

Malabsorption - Failure to absorb nutrients or final products from digestion process

Causes: Intraluminal, Mucosal, Post Mucosal.

1. Intraluminal - Structure or Enzyme def for absorption

A - Structure: Small bowel carcinoma, Ileal Crohns, err...etc. hehee.
B - Enzymes: Bile - Liver pathology: obstruction, hepatitis, biliary cholangitis.. Pancreatic - pancreatic carcinoma, chronic pancreatitis, CF....

2. Mucosal: lack of functional small bowel to absorption.

Small bowel syndrome - ileal resection due to Crohns or damaged due to pathology such as celiac disease....er...haha..thats the only small bowel mucosal patho i know due to a pathology i remember as villous atrophy i think.

3. Post mucosal: Pathology with the lymphatics absorption to system

Lymphatics circulation obstructions in some lyphomas, etc...heheheh...cannot remember la shit.

Presentation:

As per cause. Generally if u have a malabsorption, u have systemic symptoms like weight loss, malaise, tiredness...all the not enough food thing la. Plus all the vitamins or nutrients deficiencies symptoms.

Other symptoms, which i like, and i can remember is because or orlistat, a drug used by fatties. That drug causes the malabroption of fat, so u get Steatorrhea - shit float and damn smelly.

Hmm..actually i just realised I cant remmeber much liau. Hmmm...

Investigations:

So we do all the basic investigations:

Bloods, Imaging and Special Tests.

I think the most common causes would celiac disease and pancreatitis. So do those tests to rule these two out first. For celiac, an autoimmune, so can do antibodies, antigliadin or something like dat, then enteroscopy with biopsy. Then for pancreatitis, might need to some levels of enzymes, and then imaging using ultrasound first or MRCP.

Management:

As per cause. Give nutrients supplements for any deficiency and removal for any structural abnormalities.

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