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
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
Tropical sprue Any age + + + + +
  • Pallor
  • Angular stomatitis
  • Mouth ulcers
  • Edema
- -
  • Unknown
  • Bacteria including Escherichia coli, Klebsiella pneumoniae, Enterobacter cloace
  • Diagnosis of exclusion
Chronic pancreatitis 50-60 - + + + +
Cirrhosis
Atrophic gastritis
Intestinal lymphoma
Laxative abuse
Postgastrectomy syndrome
Short bowel syndrome
Agammaglobulinemia
Intestinal lymphangiectasia
Amyloidosis
Mastocytosis
Small intestinal bacterial overgrowth
Radiation enteritis
Drug induced enteritis
HIV infection
Giardiasis
Strongyloidiasis
Tuberculosis