Malabsorption Syndrome:Investigation,Specific Test

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

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MALABSORPTION SYNDROMES

Related topics

Malabsorption,
Maldigestion,Digestion and Absorption Steps

Causes of Malabsorption in children

Signs and Symptoms of malabsorption syndrome

Management and Prognosis of Malabsorption

Malabsorption Syndrome Faq's

Dr. Saumil K. Shah
MD, DNB, DM, DNB
GASTROENTEROLOGIST, HEPATOLOGIST, ENDOSCOPIST

Honorary Consultant: Lilavati Hospital And Research Centre

Q. How to you initially investigate patients with malabsorption syndrome?
A.

Blood tests	Abnormal result
Complete hemogram, Mean corpuscular volume	Anemia Microcytic - Iron deficiency Macrocytic - Vitamin B12, Folic Acid deficiency
Peripheral smear	Hypersegmentation of polymorphic nuclei - Vitamin B12, folic acid deficiency. Howell Jolly bodies - Gluten sensitivity, Crohn's disease Acanthocytes - Abetalipoproteinemia
ESR, C-reactive protein	Tuberculosis, Crohn's disease, lymphoma, IPSID, vasculitis
Prothrombin time	Vitamin K malabsorption
Serum albumin	Protein loss through gut or amino acid malabsorption
Serum calcium	Vitamin D and calcium malabsorption
Serum phosphate	Vitamin D malabsorption
Serum alkaline phosphatase	Vitamin D malabsorption
Serum cholesterol	Lipid malabsorption
Serum potassium	Increase loss due to excessive diarrhea
Serum iron, serum ferritin	Iron deficiency
Serum folate, red cell folate	Folic acid deficiency
Serum zinc	Zinc deficiency
Serum magnesium	Magnesium deficiency
Serum vitamin B12	Vitamin B12 deficiency
Stool - Routine / Microscopy	Steatorrhoea, Giardia lamblia, Neutrophils in inflammatory disease
X Ray Abdomen *	Calcification (Chronic pancreatitis)
HIV (ELISA) *	Human immunodeficiency virus
Thyroid function tests *	Hyperthyroidism
Immunoglobulin A *	Low immunoglobulin levels
Specific antibodies *	Antigliadin (IgA) / Antiendomysial (IgA) - Gluten sensitivity
Sweat chloride *	Cystic fibrosis

* Only if clinically suspected

Q. What are the specific tests to evaluate malabsorption syndrome?
A.

Test	Utility
Schilling test	To evaluate cause of vitamin B12 deficiency
Fecal fat estimation	Chronic pancreatitis, Small intestinal mucosa disease
Xylose tolerance test	Small intestinal mucosa disease
Small intestinal barium study	Small intestinal mucosa disease
Endoscopy with small intestinal biopsy	Small intestinal mucosa disease
US abdomen, CT scan abdomen	Chronic pancreatitis, Tuberculosis
ERCP	Chronic pancreatitis
Tests to evaluate pancreatic exocrine function (Tube and tubeless tests)	Chronic pancreatitis
Breath tests	Bacterial overgrowth syndrome, Lactase deficiency

Next : Management and Prognosis of Malabsorption

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