Malabsorption
Malabsorption is suspected in patients with chronic diarrhoea, weight loss and anaemia. If the history suggests a specific cause, testing should be directed to that condition. If no cause is readily apparent, blood tests can be used to screen for consequences. Test results may suggest a diagnosis and further investigation, as treatment will depend on any underlying disease or condition.
Useful reading
Waljee AK (2009). Systematic Review: Pancreatic enzyme treatment of chronic pancreatitis. Aliment Pharmacol Ther. Feb 1; 29(3): 235-246. Published online 8 Nov 2008.
doi: 10.1111/j.1365-2036.2008.03885.x www.ncbi.nlm.nih.gov/pmc/articles/PMC3462488/
Gianluca I et al (2016. )Digestive Enzyme Supplementation in Gastrointestinal Diseases. Curr Drug Metab. 2016 Feb; 17(2): 187-193. Published online Feb 2016. doi: 10.2174/138920021702160114150137 PMCID: PMC4923703
NICE (2013). Clinical Knowledge Summaries: Pancreatitis - chronic. Scenario: Management of confirmed chronic pancreatitis (age from 18 years onwards): Management in primary care. Last revised in June 2013. https://cks.nice.org.uk/pancreatitis-chronic#!scenario:1
NICE (2015). Clinical Knowledge Summaries: Crohn’s disease - established Crohn’s disease. Last revised in April 2015. https://cks.nice.org.uk/crohns-disease#!scenario
Owens SR, Greenson JK. The pathology of malabsorption: current concepts. Histopathology. 2007 Jan. 50(1): 64-82
British Society of Gastroenterology. Tests for malabsorption. Available at: www.bsg.org.uk/pdf_word_docs/malabsorbtion.pdf (accessed 14/02/17)
Ruiz Jr AR. Overview of Malabsorption. Available at: www.merckmanuals.com/professional/gastrointestinal-disorders/malabsorption-syndromes/overview-of-malabsorption (accessed 14/02/17)
Jellema P et al (2010). Lactose malabsorption and intolerance: a systematic review on the diagnostic value of gastrointestinal symptoms and self-reported milk intolerance. QJM. Aug; 103(8): 555-72. doi: 10.1093/qjmed/hcq082. Epub 3 Jun 2010. www.ncbi.nlm.nih.gov/pubmed/20522486
Crothers K. The management of Pancreatic Enzyme Replacement Therapy in Pancreatic Cancer. CN Focus. 2015 June. 7 (2): 14-16
World Gastroenterology Organisation. Prebiotics and probiotics 2011. Available at www.worldgastroenterology.org/UserFiles/file/guidelines/probiotics-english-2011.pdf (accessed 15/09/15)
Smart KM, Alex G, Hardikar W. Feeding the child with liver disease. J Gastroenterol Hepatol. 2011; 26(5): 810-815