Malabsorption – causes, early signs,symptoms and treatment of malabsorption syndrome

Malabsorption is a violation of the absorption of nutrients in
small intestine leading to serious metabolic disorders
substances. The malabsorption syndrome is accompanied by a variety
clinical manifestations: from diarrhea and abdominal pain to anemia and
hair loss.

Причины синдрома malabsorption

Мальабсорбция

What is this syndrome? Malabsorption (impaired absorption in
intestine) is a syndrome characterized by a set of clinical
manifestations (diarrhea, steatorrhea, polyhypovitaminosis, weight loss),
developing due to disorders of the digestive and transport
functions of the small intestine, which in turn leads to
патологическим изменениям обмена substances.

In most cases, malabsorption syndrome first appears.
in the first year of a child’s life. This is due primarily to
change in nutrition, because in the beginning the child gets maternal
milk or a special mixture instead of mom’s milk, but soon begins
get the first lure, then the diet is already large
product range – this is where malabsorption manifests itself
all their bad sides.

Usually the cause of malabsorption syndrome is severe.
disease in the body, most often a disease of the digestive system
or disease of other body systems causing damage
small intestine. The cause of malabsorption can be:

  • stomach diseases,
  • the liver
  • pancreas,
  • cystic fibrosis
  • infectious, toxic, allergic lesions of the thin
    intestine.
Mechanism Causes
Insufficient mixing of gastric contents
and / or fast gastric emptying
  • Billroth’s stomach resection II. Gastrointestinal
    fistula.
  • Gastroenterostomy
Lack of components necessary for digestion
  • Obstruction of the biliary tract and cholestasis.
  • Cirrhosis of the liver.
  • Chronic pancreatitis.
  • Loss of bile acids while taking cholestyramine.
  • Cystic fibrosis.
  • Lactase deficiency.
  • Pancreas cancer. Pancreatic resection.
    Shortage of sucrase-isomaltase
External conditions under which enzyme activity
depressed
  • Motility disorders in diabetes, scleroderma,
    hypothyroidism or healtireosis.
  • Excessive bacterial growth with blind loops,
    diverticula of the small intestine.
  • Zollinger – Ellison Syndrome
Acute epithelial damage
  • Acute intestinal infections.
  • Alcohol.
Chronic epithelial damage
  • Amyloidosis.
  • Celiac disease
  • Crohn’s disease.
  • Ischemia.
  • Radiation enteritis.
Short bowel syndrome
  • Состояние после резекции intestine.
  • The imposition of the iliac anastomosis for the purpose of treatment
    obesity
Traffic violations
  • Adison’s disease.
  • Блокада лимфатических сосудов при лимфоме или
    tuberculosis.
  • Internal factor deficiency (with pernicious anemia).

Виды и степени синдрома

Malabsorption syndrome can be either congenital or
acquired:

  • Congenital type of pathology is diagnosed in 10% of cases. Usually
    it can be identified in the first few days of the child’s life.
  • Acquired malabsorption in children can begin
    to progress at any age against the background of existing pathologies
    intestine, stomach, liver.

Malabsorption syndrome is caused by a violation
пищеварительно-транспортной функции тонкого отдела intestine. It,
in turn, provokes metabolic disorders. Syndrome
malabsorption has three severity:

  • 1 degree – weight loss, increasing general weakness, poor
    performance;
  • 2 degree – there is a rather noticeable loss of body weight
    (более 10 кг), анемия, присутствуют нарушения функций  половых
    glands, pronounced symptoms of deficiency of potassium, calcium, many
    vitamins;
  • Grade 3 – severe weight loss, vivid clinical picture
    electrolyte deficiency, anemia, edema, osteoporosis, disorders
    endocrine nature, sometimes there are convulsions.

Симптомы malabsorption

The nature of the clinical manifestations of pathology is directly dependent on
of what caused its development. Therefore, to the fore
violations of protein, fat, carbohydrate or
water-salt metabolism. There may also be signs of vitamin
failure.

Violation of the absorption of substances causes diarrhea, steatorrhea, bloating
belly and gas formation. Other symptoms of malabsorption are
следствием дефицита питательных substances. Patients often lose in
weight, despite adequate diet.

Doctors highlighted a list of symptoms that are characteristic of
malabsorption:

  1. Diarrhea (diarrhea). The chair becomes very frequent, in day
    there may be 10-15 feces, feces – offensive, mushy,
    may be watery.
  2. Стеаторея (жирный стул). Feces become oily,
    the naked eye can see a brilliant bloom on it, patients
    note that feces are difficult to wash off the toilet.
  3. Боли в животе. They usually arise after
    eating food is always accompanied by a loud rumbling
    disappear after taking drugs with antispasmodic or
    anesthetic action.
  4. Слабость в мышцах, постоянное ощущение жажды. This
    symptom occurs on the background prolonged diarrhea – the body loses too
    a lot of fluid, which is manifested by these signs.
  5. Изменение внешнего вида. The man notes the fragility and
    tendency to stratification of the nail plate, hair on the head is active
    fall out, the skin becomes dull and become gray
    shade.
  6. Снижение веса. Slimming occurs without the application
    no effort on the part of the patient. At the same time he continues
    eat fully, he has a hypodynamic lifestyle.
  7. Повышенная утомляемость. Manifested by a decrease
    performance, constant drowsiness (and, at night, the patient
    worried about insomnia), general weakness.

All patients suffering from malabsorption syndrome are prone to
progressive weight loss.

Complications

Syndrome malabsorption может стать причиной следующих
complications:

  • дефицит различных vitamins;
  • anemia;
  • menstrual disorders in women;
  • severe weight loss or poor weight gain in children;
  • deformation of the bones of the skeleton.

The diagram shows the mechanism of formation of complications in the syndrome
malabsorption

Diagnostics

Diagnostics синдрома malabsorption достаточно простая, но
laborious. This requires a series of not only laboratory tests.
research, but also instrumental:

  1. history taking and symptom assessment;
  2. primary inspection. With the help of palpation, the doctor has the opportunity
    identify the tension of the anterior abdominal wall, as well as areas on
    stomach, in which the patient feels pain;
  3. blood test. При malabsorption отмечается снижение
    hemoglobin as well as red blood cells;
  4. blood biochemistry;
  5. coprogram. In the excrement can be detected dietary fiber,
    undigested food particles, fats, etc;
  6. Ultrasound;
  7. esophagogastroduodenoscopy;
  8. colonoscopy;
  9. CT or MRI.

What you need to inspect?

loading...
  • Small intestine (small intestine)
  • Large intestine (large intestine)

What tests are needed first?

  • General blood analysis
  • Stool analysis

Diagnosis should be made only after
comprehensive examination of the patient.

Лечение синдром malabsorption

В первую очередь лечение malabsorption должно быть направлено на
лечение заболевания, ставшего причиной синдрома malabsorption.
For example, pancreatitis is treated with enzyme and antispasmodic
drugs, cholecystitis – choleretic and antispasmodic
drugs, gallstone disease – antispasmodics or perform
surgery, malignant tumors – carry out the operation.

Лечение malabsorption можно разделить на три основных вида:

  • Diet therapy;
  • Drug treatment;
  • Surgical method.

Diet

Diet

It is assigned individually, depending on which
It is the nutrient that is not absorbed. For example, with congenital
malabsorption на фоне целиакии необходимо устранить все продукты,
containing gluten. If lactose intolerance is removed from the diet
fresh milk.

Diet должна строится на:

  • fractional nutrition;
  • the use of increased amounts of vegetables and fruits (to
    make up for vitamin deficiency);

It is necessary to refuse:

  • alcohol
  • spicy food
  • fast food and convenience foods,
  • fatty meat
  • ice cream and very cold drinks.

The patient must make the diet himself by observing his
condition. Find out which foods lead to deterioration
symptoms, and discard them.

Медикаментозное лечение malabsorption

Drug treatment of the disease in turn
includes:

  1. Drugs, corrective vitamin deficiencies and
    minerals;
  2. Antibacterial drugs;
  3. Antacid therapy;
  4. Hormonal therapy;
  5. Choleretic medication;
  6. Anti-diarrheal and antisecretory drugs;
  7. Pancreatic enzymes.

Operation

Surgical methods are used depending on the main
pathology leading to the development of the syndrome. So operational
intervention is performed in patients with ulcerative complications
colitis, liver diseases, Hirshpung and Crohn’s diseases,
intestinal lymphangiectasia.

The basis of successful treatment is as early as possible.
диагностирование заболевания и чем раньше начать терапию, тем
less chance for deep metabolic shifts.

Forecast

Иногда в легких случаях синдром malabsorption корректируется с
using diet. In other cases, the prognosis for this disease.
directly depends on the course of the main pathology, severity
impaired absorption and insufficient intake of substances in
blood.

If the main factor causing this syndrome is
eliminated, correction of the effects of prolonged dystrophy may
require a long time.

Прогрессирование malabsorption грозит развитием терминальных
states and can lead to death.

Prevention methods

  1. Prevention and timely treatment of diseases of the organs
    gastrointestinal tract (enterocolitis, cholecystitis, gastritis,
    pancreatitis, etc.).
  2. Diagnostics и лечение наследственных заболеваний: муковисцидоза
    (Systemic hereditary disease, which affects
    exocrine glands), celiac disease (hereditary disease,
    associated with a lack of enzymes (substances involved in the process
    digestion), splitting protein cereals – gluten).
  3. Regular reception vitamins, periodic course of taking
    enzyme preparations.
  4. Periodic course of the state of the digestive tract organs – ultrasound
    abdominal, endoscopy, gastric intubation, etc.
  5. You need to lead a healthy lifestyle – stop smoking
    alcohol избегать стрессов и нервных срывов.

Если синдром malabsorption не лечить, то он быстро
progresses: depletion of the body can lead to
a variety of pathologies, including liver failure,
at which the risk of death of the patient increases.

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