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This condition is a state of impaired absorption of nutrients in the small intestine. The main purpose of the Gastrointestinal tract is the digestion and absorption of major nutrients (fat, carbohydrate, and protein), essential micronutrients (vitamins and trace minerals), water, and electrolytes. Digestion involves both mechanical and enzymatic breakdown of food. The final products of digestion are absorbed through the intestinal epithelial cells. A defect in any one of these processes may produce a state of malabsorption. The following findings suggest that intestinal malabsorption is occurring:- Increased number and size of fat globules in stool
- increased neutral fat (unsplit fats) indicates impaired fat digestion
- increased free fatty acids (split fats) indicates normal fat digestion but impaired fat absorption
- Increased quantity of fat in 72-hr stool sample after the patient has been on a 100-g fat diet daily for three days
- Decreased serum carotene indicates fat malabsorption or decreased dietary intake of carotene.
- Impaired D-xylose tolerance test (decreased urinary excretion of a measured amount of ingested xylose) indicates impaired jejunal mucosal absorption of xylose. Because this carbohydrate does not require digestion by pancreatic enzymes, the tolerance test is normal in pancreatic insufficiency and does not indicate maldigestion.
- Decreased serum levels of total protein, albumin, y-globulin, iron, folate, vitamin B12, calcium, phosphorous, magnesium, and cholesterol result from impaired intestinal absorption.
- Anemia - macrocytic, due to impaired absorption of folate or vitamin B12; microcytic, due to iron deficiency
- Increased urine oxalate accompanying steatorrhea indicates an increase in colonic absorption of oxalates and their excretion in urine.
- Prolonged prothrombin time results from impaired vitamin-K absorption.
- Intestinal biopsy may show mucosal villous atrophy, tumor, or inflammation.
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