What is malabsorption?

Related links:

• Our services: How we care for children with malabsorption disorders

Related tests and treatments:

• Blood tests
• Endoscopy
• Stool tests
• Sweat test

About malabsorption

When we eat food, our bodies normally break down the food into little pieces so that it can be digested and the nutrients from the food can be absorbed into the bloodstream. Malabsorption occurs when the body isn’t able to break down the food or absorb it properly, depriving the body of the nutrients it needs to sustain itself and grow. This condition is often associated with failure to thrive, poor weight gain and weight loss.

What causes malabsorption?

There are several conditions that can lead to malabsorption, including short bowel syndrome, celiac disease, cystic fibrosis, Crohn’s disease, lactose intolerance and chronic pancreatitis. Depending on the condition, the problem might be that the child lacks a necessary enzyme to digest a particular food (for example, milk sugar in patients with lactose intolerance) or that something has affected the body’s ability to absorb all nutrients (such as in celiac disease, where exposure to gluten damages the lining of the small intestine). Severe malabsorption can occur with short bowel syndrome, where the child does not have enough length of intestine to digest and absorb the nutrients from food effectively.

How often does malabsorption occur?

Prevalence rates vary depending on the underlying condition, but overall, malabsorption is uncommon in children. Celiac disease affects 1 percent of the population.

How does malabsorption develop?

Malabsorptive disorders are often inherited, but malabsorption can also develop later, such as after a bout of severe pancreatitis or a parasitic infection. Temporary lactose intolerance can affect anyone after a gastrointestinal illness, such as the common stomach flu, but it doesn’t typically hinder growth.

What are the symptoms of malabsorption?

This condition’s symptoms can include:

• Diarrhea
• Oily, foul-smelling stools
• Poor growth
• Abdominal distension
• Belly pain
• Diaper rashes in babies

Who is at risk of developing this condition?

A child’s ethnic heritage can play a role. Caucasians are at higher risk for celiac disease; Asians and African Americans are more likely to develop lactose intolerance; and congenital sucrose-isomaltase deficiency is more common among the Inuit of Alaska, Canada and Greenland.

Why is malabsorption a concern?

Malnutrition can lead to failure to thrive, poor weight gain and weight loss, which can affect a child’s brain growth and adult height if untreated. Persistent diarrhea and abdominal pain can also hinder a child’s quality of life.

How is malabsorption diagnosed/evaluated?

If your child’s doctor suspects malabsorption based on poor growth, persistent diarrhea or other symptoms, he or she might order one or more of the following tests:

• Stool test: A high amount of unabsorbed sugars or fat in the stool can be a sign of malabsorption.
• Blood tests: These are used to diagnose celiac disease or check for deficiencies.
• Endoscopy: The intestinal lining might be checked for inflammation or infection and is usually necessary to confirm celiac disease.
• Hydrogen breath test: A high level of hydrogen in your child’s breath after he or she drinks milk sugar can indicate lactose intolerance.
• Sweat test: Sweat is collected from the skin to check for cystic fibrosis.

What is the treatment for malabsorption?

Treatment varies by disorder, but it often involves diet changes. Children who have trouble digesting lactose or sugar will need to avoid those foods or take oral medications to replace necessary digestive enzymes. Children with celiac disease should avoid gluten. In some cases, such as with short bowel syndrome, children might require nutritional supplementation through an intravenous solution.

What happens after treatment?

Most malabsorptive disorders are chronic conditions that require ongoing treatment. Your pediatrician will continue to monitor your child’s weight and symptoms to ensure that your child is adequately nourished.

When should you contact a physician?

If your child has persistent diarrhea, oily stools, poor weight gain or other concerning symptoms, talk to your pediatrician.

What is the long-term outlook for malabsorption?

In some cases, malabsorptive disorders are lifelong conditions. Outlook varies depending on your child’s particular diagnosis, but with proper treatment and diet modifications, many children go on to live normal lives.

How do I live with malabsorption?

Follow your doctor’s advice regarding diet modifications and any necessary medications. Not only will that help alleviate your child’s symptoms, but it will ensure the proper nutrition that is vital for your child’s growth and wellbeing.

For more information about this condition, visit the International Foundation for Functional Gastrointestinal Disorders.