What Is Intestinal Malabsorption?

Intestinal malabsorption is a condition in which the small intestine is unable to absorb enough nutrients, vitamins, or minerals from food. This results in nutritional deficiencies and a variety of gastrointestinal and systemic symptoms.

It can affect the absorption of carbohydrates, proteins, fats, vitamins, and minerals, either selectively or broadly. The severity and symptoms vary depending on the underlying cause and the specific nutrients not absorbed properly.

What Causes Intestinal Malabsorption?

Several conditions and factors can interfere with the absorption process:

Digestive Enzyme Deficiencies:

• Lactose intolerance (lack of lactase enzyme)
• Pancreatic insufficiency (e.g., in chronic pancreatitis or cystic fibrosis)

Damage to the Intestinal Lining:

• Celiac disease
• Tropical sprue
• Radiation enteritis
• Infections (e.g., Giardia, HIV)

Structural Abnormalities:

• Short bowel syndrome (from surgical removal of part of the intestine)
• Intestinal bypass surgery

Other Causes:

• Crohn’s disease
• Bile salt deficiency (affects fat absorption)
• Certain medications (e.g., orlistat, antibiotics)
• SIBO (small intestinal bacterial overgrowth)

What Are the Symptoms of Intestinal Malabsorption?

Symptoms depend on which nutrients are not being absorbed but often include:

• Chronic diarrhea
• Bulky, foul-smelling, or greasy stools (steatorrhea)
• Weight loss despite adequate food intake
• Bloating and gas
• Fatigue and weakness
• Nutritional deficiencies, such as:
  • Iron → anemia
  • Vitamin D → bone pain, osteoporosis
  • Vitamin B12 → numbness, memory issues
  • Vitamin K → easy bruising or bleeding

In children, it may cause growth delay or failure to thrive.

How Is Intestinal Malabsorption Diagnosed?

Diagnosis involves a combination of clinical evaluation and specialized testing:

• Stool tests (for fat content, infections, or parasites)
• Blood tests (to assess nutrient levels and signs of deficiencies)
• Breath tests (e.g., hydrogen breath test for lactose intolerance or SIBO)
• Endoscopy with biopsy (to assess the intestinal lining, especially in celiac disease)
• Imaging studies (CT, MRI, or barium studies)

A thorough medical history, including diet and any previous gastrointestinal disorders, is essential.

How Is Intestinal Malabsorption Treated?

Treatment focuses on the underlying cause and nutritional support:

1. Treating the Cause:

• Gluten-free diet for celiac disease
• Antibiotics for infections or SIBO
• Enzyme replacement therapy for pancreatic insufficiency
• Surgical correction if there is a structural issue

2. Nutritional Therapy:

• Vitamin and mineral supplements
• High-calorie or specialized diets
• Fat-soluble vitamin supplementation (A, D, E, K)
• Parenteral nutrition (IV feeding) in severe cases

A dietitian’s guidance is often recommended to ensure proper nutrient intake.

What Are the Complications of Intestinal Malabsorption?

If untreated, malabsorption can lead to:

• Severe malnutrition
• Osteoporosis or bone fractures
• Anemia
• Immune dysfunction
• Growth delays in children
• Neurological issues (due to B12 or vitamin E deficiency)

Long-term deficiencies may affect overall quality of life and organ function.

How Can Intestinal Malabsorption Be Prevented?

While some causes can’t be prevented, certain steps may help reduce the risk:

• Treat underlying digestive conditions early
• Avoid known triggers (e.g., gluten in celiac disease)
• Practice good food hygiene to avoid infections
• Monitor nutrient levels in high-risk individuals
• Follow dietary recommendations after bowel surgery

Regular check-ups and early intervention can help manage or even prevent complications.