Sandbox: malabsorption

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Abbreviations: WBC: White blood cells; Plt: Platelets, Hgb: Hemoglobin, IgE: Immunoglobulin E, IgA: Immunoglobulin A

Cause Peak age of onset History Physical exam Lab findings Additional findings Cause/Pathogenesis Gold standard diagnosis
Fever Abdominal pain Diarrhea Weight loss
Watery Fatty WBC Hgb Plt Other lab findings
Whipple's disease 40-60 ± + + + + ↓/↑
Celiac disease Childhood

Adult

- + ± ± + - -
  • IgA endomysial antibody
  • Anti-tissue transglutaminase antibody
  • Anti-gliadin antibody
  • IgA endomysial antibody
  • IgA tissue transglutaminase antibody
Tropical sprue Any age + + + + + - -
  • Diagnosis of exclusion
Crohns disease Young adults

(20th)

+ + + + +
  • Abnormal immune response to self antigens
Ulcerative colitis Young adults

(20th)

+ + + + +
  • Hypoalbuminemia
  • Hypokalemia
  • Hypomagnesemia
  • Iron deficiency
  • Elevated ESR
  • Elevated CRP
  • Abnormal immune response to self antigens
Cystic fibrosis Childhood

Adult

± + - + + - -
  • Positive DNA analysis for CFTR
  • Evaluated nasal transepithelial potential difference (NPD)
VIPoma 30-50 - + + + + - - -
  • Primary secretory tumor
  • Elevated VIP levels
  • Followed by imaging
Zollinger-Ellison syndrome 20-50 - + + + + - -
  • Elevated basal or stimulated serum gastrin> 120 pg/mL
Eosinophilic gastroenteritis  30th - + + + + - -
Primary bile acid malabsorption Childhood Adult - + + + + - -
Abetalipoproteinemia Infancy

Adult

- + + + + - - -
Microscopic colitis 50-70 - + + - + - -
Hyperthyroidism Any age ± + + - + - - -
  • Elevated T4
  • Elevated T3
  • Decreased TSH
Lactose intolerance Any age - + + - - - - -
Irritable bowel syndrome 30-50 - ± ± ± - - - -
  • Diagnosis of exclusion
Chronic pancreatitis 50-60 - + + + +
Cirrhosis 50-60 + + + + +
Short bowel syndrome
Intestinal lymphoma
Agammaglobulinemia
Intestinal lymphangiectasia
Amyloidosis
Mastocytosis
Small intestinal bacterial overgrowth
Drug induced enteritis
HIV infection
Giardiasis
Strongyloidiasis
Tuberculosis