Refers to intestinal malabsorption syndrome a set of disorders derived from an alteration of nutrient absorption in the digestive tract. This alteration can be due to several causes: inflammatory, genetic, infectious…
Depending on its origin, it can be global or specific to a particular nutrient. Once the mechanism that produces it has been diagnosed, the necessary treatment will be addressed. Let’s see more below.
physiology of digestion
Digestion is a process that consists of breaking down the food we eat into simpler components and absorb them in the intestine.
This process It starts in the mouth, with chewing. The food is broken into smaller pieces and mixed with saliva; thus forming the food bolus. Furthermore, fats (lipids) and carbohydrates begin to be broken down by the action of salivary enzymes.
The food bolus passes into the esophagus and reaches the stomach. In this organ, hydrochloric acid and enzymes are released that digest proteins and fats into simpler compounds.
The mass that has formed in the stomach is called chyme and passes into the small intestine. In this section of the digestive tract, pancreas and liver release pancreatic juices and bile, respectively.
- Pancreatic juice contains many enzymes to complete digestion, such as trypsin and amylase. Trypsin activates other enzymes involved in protein digestion. Meanwhile, amylase is responsible for digesting carbohydrates. It is also essential in the digestion of fats.
- The bile produced by the liver contains bile salts, Indispensable for emulsifying fats. This process consists in forming small lipid aggregates called micellesso they can be absorbed in the small intestine.
It is in this section that the “true digestion” takes place. Once the simple molecules that come from the breakdown of food are obtained, the intestinal cells absorb them so that they pass into the blood.
The cells of the small intestine are called enterocytesand they have molecules and enzymes that allow minerals, lipids, vitamins, carbohydrates and proteins to pass into the blood. 90% of absorption occurs in the small intestine.
waste products pass into the large intestine where the formation of feces takes place, which are expelled through the anus. Some nutrients are also absorbed in this intestinal section, mainly minerals and water.
Therefore, digestion is a very complex process, regulated by multiple organs and glands. A failure in any of the parts involved can produce intestinal malabsorption syndrome.
As indicated the MSD manualthe serious thing is that “malabsorption causes deficiencies of all nutrients or selective deficiencies of proteins, fats, sugars, vitamins or minerals”.
Fat malabsorption
Once the stages of lipid digestion have been explained, a malabsorption of the same It can be due to several causes:
- Pancreatic insufficiency: pancreatic juices are needed to assimilate fats. If its production is insufficient, there may be fat malabsorption. This is what can happen in patients with pancreatitis.
- Deficiency of bile salts: bile salts can decrease due to liver disease or blockages in the bile ducts, which connect the liver to the small intestine so that bile reaches the digestive tract. If there are no bile salts or they don’t reach the intestines, fats aren’t absorbed.
- Alteration of the intestinal mucosa: inflammation of the intestinal mucosa can alter the digestion of nutrients. This is what happens in intestinal infections or inflammatory diseases such as Crohn’s disease.
- gastrectomies: These are surgical interventions which consist in the removal of a damaged part of the stomach. One of its consequences is to alter digestion, therefore an alteration of the digestive functions of the stomach can cause intestinal malabsorption syndrome.
fat malabsorption clinic
A malabsorption of lipids may cause the following symptoms:
- Steatorrhea: It is the presence of fat in the stool as it is not absorbed. This can be verified by observing that the stool is lighter and floats in the toilet.
- Weight loss: since lipids are a source of energy and constitute an important energy reserve.
- derived symptoms from non-absorption fat-soluble vitamins. These vitamins need the same mechanisms as lipids, so they aren’t even absorbed. The fat-soluble vitamins are A, D, E, K and F.
Protein malabsorption
The triggers are similar to those described for lipids:
- gastrectomies.
- Pancreatic insufficiency: Trypsin is needed to break proteins into smaller compounds.
- Deficiency of bile salts: These are required for trypsin to function properly. In this case, intestinal protein malabsorption will be less.
Protein malabsorption clinic
Protein is a vital component in muscles, therefore if its absorption fails, there will be a significant decrease in muscle mass. As a result, weight loss can also occur.
In the most serious cases, a protein deficiency can cause a decrease in albumin (hypoalbuminemia), an essential protein in the blood. If this decreases, there is a significant impairment of circulatory function which can cause fluid to accumulate in the legs and cause them to swell; technically, this is called edema.
Carbohydrate malabsorption
In this case, malabsorption is usually specific, as a consequence of an alteration of the intestinal mucosa. Enterocytes contain enzymes needed for the final part of carbohydrate digestion; If these enzymes don’t work, carbohydrate absorption is impaired.
The most characteristic form is lactose intolerance. The same happens if there is inflammation of the intestinal mucosa due to infections or inflammatory diseases, such as celiac disease.
Carbohydrate malabsorption clinic
Carbohydrates are the main source of energy, especially for getting energy quickly. A lack of its absorption will produce weight loss. Furthermore, the presence of unabsorbed carbohydrates irritates the intestinal mucosa, causing watery diarrhea.
Although less frequent, there may also be situations in which intestinal malabsorption syndrome occurs It is due to the lack of absorption of water, mineral salts and vitamins.
In all cases, you need to inform yourself about eating habits, as some deficits result from insufficient intake. Likewise, general intestinal problems, such as infections or surgery, must be ruled out.
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