Malabsorption other diagnostic studies

Malabsorption
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Classification Infection Structural defect Digestive failure Systemic disease Iatrogenic
Differentiating Malabsorption from other Diseases

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Other Diagnostic Studies

Radiological Studies

• Barium follow through is useful in delineating small intestinal anatomy. Barium enema may be undertaken to see colonic or ileal lesions.
• CT abdomen is useful in ruling out structural abnormality, done in pancreatic protocol when visualising pancreas.
• MRCP to complement or as an alternative to ERCP

Interventional Studies

Biopsy of small bowel showing coeliac disease manifested by blunting of villi, crypt hyperplasia, and lymphocyte infiltration of crypts.

• Endoscopy is frequently undertaken, but to visualize small intestine which can be up to 7m long is indeed a daunting task.

(a) OGD to reveal duodenal lesion also for D2 biopsy (for celiac disease, tropical sprue, Whipple disease, A-b-lipoproteinemia etc.)

(b) Enteroscopy for enteropathy and jejunal aspirate and culture for bacterial overgrowth

(c) Colonoscopy is helpful in colonic or ileal lesion.

• ERCP

Other Investigations

• Radio isotope tests e.g. 75SeHCAT, 95mTc to exclude terminal ileal disease.
• Sugar probes or sub 51Cr-EDTA to determine intestinal permeability.
• Glucose hydrogen breath test for bacterial overgrowth
• D-xylose absorption test. lower level in urine after ingestion indicates bacterial overgrowth or reduced absorptive surface. normal in pancreatic insufficiency.
• Bile salt breath test to determine bile salt malabsorption.
• Schilling test to establish cause of B12 deficiency.
• Lactose H2 breath test for lactose intolerance