Malabsorption Syndromes

Saumil K. Shah
When Does One Suspect That a Child has Malabsorption Syndrome?
Progressive weight loss
Failure to thrive
Chronic diarrhea
Edema feet
Weakness, Malaise, Fatigue
Abdominal distension
Borborygmi, Excessive flatus
Abdominal pain
Symptoms reflecting specific deficiencies, such as bleeding tendency, muscle cramps, tetany, bone pains and paresthesias
Symptoms related to cause of malabsorption

Steatorrhea is pale, soft, bulky, malodorous stools that stick to the side of the toilet bowl or float and are difficult to flush away. Steatorrhea indicates excess amount of malabsorbed fat in stools.

MassTuberculosis, lymphoma, Crohn's disease
DistensionAscites (hypoproteinemia, tuberculosis), pancreatic pseudocyst
Steatorrheic stool
Pancreatic insufficiency, small intestinal mucosa disease
Extra intestinal 
NonspecificPigmentation, thinning, inelasticity, reduced subcutaneous fat
SpecificPetechiae (Vitamin K deficiency), edema (hypoproteinemia), erythema nodosum (Crohn's disease), dermatitis herpetiformis (celiac sprue)
Alopecia, thinningGluten sensitivity, generalized inanition
Conjunctivitis, episcleritisCrohn's disease
PalenessSevere anemia
Aphthous ulcersGluten sensitivity, Crohn's disease
GlossitisDeficiencies of vitamin B12, iron, folic acid and niacin
Angular cheilosisDeficiencies of vitamin B12, iron, folic acid and vitamin B complex
Dental hypoplasiaGluten sensitivity
ClubbingGluten sensitivity, Crohn's disease, tuberculosis, lymphoma
KoilonychiaIron deficiency
Mono / polyarthropathyGluten sensitivity, Crohn's disease, Whipple's disease
Back painGluten sensitivity, Crohn's disease
Muscle weaknessDiffuse mucosal disease, lymphoma
Nervous system 
Peripheral neuropathyVitamin B 12 deficiency
Cerebral (seizures, dementia, cranial nerve palsies)Whipple's disease, gluten sensitivity, diffuse lymphoma

This occurs since small intestinal mucosal diseases causes secondary lactase deficiency. Lactase is necessary for the digestion of lactose, the disaccharide present in milk.

Malabsorption Syndromes Malabsorption Syndromes 02/20/2001
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