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Malabsorption: Causes, symptoms, and diagnosis

Some commonly known disorders related to malabsorption are lactose intolerance and celiac disease. People with a history of bowel or stomach surgery may also have malabsorption disorders.

Because malabsorption affects a person’s abilities to get nutrients from food, it is essential that they see a doctor to get a diagnosis and treatment as quickly as possible.

Causes and types

Malabsorption is the result of a disruption in at least one part of a person’s digestion.

Digestion begins when the enzymes in a person’s saliva start to break down food into smaller parts that the body can absorb.

Enzymes continue to break down the food as it travels through the esophagus, stomach, and large and small intestines before it leaves the body as waste products.

Malabsorption can occur if someone does not have enough digestive enzymes, bacteria or other foreign invaders are present, or movement in the small or large intestine is faster than usual.

There are many different malabsorption disorders, each having a different underlying cause. Doctors usually classify malabsorption disorder types by the symptoms they cause.

According to the Semmelweis University School of Medicine, these categories include:

Cardiovascular disorders

  • congestive heart failure
  • constrictive pericarditis
  • mesenteric vascular insufficiency

Drug-induced disorders

Taking the following medications can lead to malabsorption disorders:

  • cholestyramine
  • colchicine
  • irritant laxatives
  • neomycin
  • phenindione

Impaired digestion

  • gastric surgery, such as gastric bypass or weight-loss surgery
  • gastrinoma

Inadequate absorptive surface

  • jejunoileal bypass
  • short bowel syndrome


  • acute infectious enteritis
  • parasitic infections, such as giardia, or helminthiasis
  • tropical sprue
  • Whipple’s disease

Intestinal mucosa abnormalities

  • amyloidosis
  • Crohn’s disease
  • cystinuria
  • eosinophilic enteritis
  • non-tropical sprue

Lymphatic obstruction

  • intestinal lymphoma
  • lymphangiectasia
  • tuberculosis

Reduced bile salt concentration

  • bacterial overgrowth from the small intestine
  • ileal resection or disease
  • liver disease

Some types of malabsorption syndromes do not fall under any category. These include conditions, such as diabetes mellitus, carcinoid syndrome, and mastocytosis.

What are the symptoms?

Malabsorption symptoms vary according to the cause, the severity of the condition, and how long a person has had the disorder.

Examples of some immediate malabsorption symptoms that may occur:

  • bloating and stomach distention
  • diarrhea
  • fatigue
  • gas
  • steatorrhea, or stool that is pale to white
  • stools that appear “greasy” in texture
  • stomach cramping
  • weakness

People need nutrients from food to maintain a healthy body. When their body cannot properly absorb these nutrients, they might experience the more long-term effects of malabsorption.

These include:

  • bone pain
  • bones that fracture easily
  • iron-deficiency anemia, which can result in shortness of breath
  • muscle wasting
  • a sore tongue
  • weight loss

Treatment options depend upon the underlying cause.

For example, doctors will treat malabsorption caused by lactose intolerance in a different way to malabsorption due to liver disease.

Initially, a doctor may recommend that a person avoids the food type that is causing the malabsorption, such as lactose or gluten-containing foods.

The doctor can evaluate the nutrients present in this food type and make recommendations on supplementation as a means of enhancing nutritional intake.

A doctor may also make recommendations for replacing missing enzymes or prescribing medications to enhance appetite. People may also choose to meet with a registered dietitian to establish a diet that is nutritious, but less likely to cause unpleasant symptoms associated with malabsorption.

A doctor will likely recommend frequent follow-up appointments to assess the effectiveness of the treatment and make new recommendations if necessary.


The complications associated with malabsorption depend upon the severity of the underlying condition.

Malabsorption can lead to weight loss, malnutrition, and even failure to thrive in many people.

A person can also experience impaired wound healing, a deficient immune system, and low energy levels.


Malabsorption syndromes can have a dramatic effect on a person’s life.

Anyone who notices their symptoms become more frequent and less occasional should see a doctor as soon as possible. This way, they can receive treatment before they experience significant unwanted weight loss and other side effects.

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