Malabsorción gastrointestinal

What are the symptoms of gastrointestinal malabsorption?

There may be no symptoms if the malabsorption is mild and has not continued for very long. More severe or persistent malabsorption may lead to:

Cansancio (fatiga)

This is because of a lack of energy as you are not absorbing nutrients and essential vitamins and minerals from food.

Pérdida de peso

If you can't absorb enough energy (calories) from your food then this will cause you to lose weight (and may cause poor growth in children).

Persistent (chronic) diarrhoea

This is a common symptom of persistent malabsorption.

Pale, bulky and smelly stools (steatorrhoea)

This is because there is excessive fat in the stools and they become pale, bulky and very smelly. Fatty stools float and are difficult to flush away. They often leave a greasy rim around the pan.

Intestinal malabsorption may also cause:

• Deficiencia de hierro y anemia por deficiencia de hierro.

• Folate deficiency.

• Deficiencia de vitamina B12.

• Abnormal bleeding, caused by low vitamin K.

• Vitamin D deficiency including rickets and osteomalacia.

• Edema, which occurs because of insufficient protein and calories absorbed into the body.

There may also be other symptoms due to the particular underlying condition that is causing the malabsorption.

The most common causes in the UK are enfermedad celíaca, enfermedad de Crohn and chronic pancreatitis. However, the malabsorption of simple carbohydrates affects about 1 in 4 people in Europe. Some diseases associated with malabsorption are found more often in some families - for example, coeliac disease, Crohn's disease, fibrosis quística and lactose intolerance.

The causes of gastrointestinal malabsorption include:

Problems with absorbing food from the gut (bowel) into your body

• Enfermedad celíaca - a long-term disease that mostly affects the small intestine.

• Intolerancia a la lactosa.

• Alergia a la proteína de la leche de vaca.

• Soya milk intolerance.

• Fructose intolerance.

• Infection - for example, intestinal tuberculosis, la diarrea del viajero.

• Immune deficiency - for example, infección por VIH.

• Pancreatic insufficiency - for example, fibrosis quística, pancreatitis crónica, cáncer de páncreas.

• Bile salts and acid malabsorption.

Structural causes

Malabsorption may be cause by loss of part of the bowel that is essential to absorb the broken down (digested) food into the body - for example:

• Removal of the stomach or part of the bowel after a stomach or bowel operation.

• enfermedad de Crohn.

Causes outside the bowel

Ejemplos incluyen:

• An glándula tiroides hiperactiva (hipertiroidismo).

• Eating disorders: anorexia nerviosa, bulimia nerviosa.

Initial tests will include análisis de sangre y stool tests. Further tests may include an abdominal ultrasonido, barium studies and a tomografía computarizada (TC) o una escaneo de resonancia magnética (IRM). Any further tests will depend on the likely underlying cause of the intestinal malabsorption.

The treatment will mainly depend on the underlying cause of the malabsorption. However, treatment will also be needed to increase the amount of essential nutrients in the body, including carbohydrates, proteins, fats, minerals and fat-soluble vitamins (nutritional support).