malabsorptio

Malabsorptio, also known as malabsorption, is a clinical syndrome characterized by impaired absorption of nutrients in the small intestine, leading to malnutrition and a range of gastrointestinal and systemic symptoms. The term covers disorders that affect the mucosal lining, the digestive secretions, or the transit and absorptive processes of the gut. Fat malabsorption is a common and hallmark feature, often presenting with steatorrhea (oily, bulky stools).

Causes are diverse and typically classified by the site or mechanism of failure. Mucosal diseases such as celiac disease and Crohn’s disease damage the lining and reduce absorption. Pancreatic insufficiency from chronic pancreatitis or cystic fibrosis impairs enzyme production needed for digestion. Bile acidity disorders, including bile acid malabsorption, disrupt fat emulsification. Small intestinal bacterial overgrowth, infections (for example giardiasis), and post-surgical changes after bariatric or extensive intestinal resection can also cause malabsorption. Medications such as orlistat can reduce fat absorption, while certain conditions like short bowel syndrome produce reduced absorptive surface.

Clinical presentation ranges from chronic diarrhea and weight loss to fatigue, weakness, and signs of specific nutrient deficiencies (iron, vitamin B12, fat-soluble vitamins A, D, E, K). Diagnosis typically relies on history and targeted tests, including fecal fat measurement, D-xylose testing, breath tests for carbohydrate malabsorption or SIBO, serology and biopsy for celiac disease, and endoscopic evaluation when indicated.

Treatment focuses on addressing the underlying cause and supporting nutrition. This may involve dietary modifications (for example, reduced fat or lactose-containing foods), pancreatic enzyme replacement, fat-soluble vitamin supplementation, and treatment of deficiencies or infections. Prognosis depends on the underlying etiology and the effectiveness of management.