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

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 visualizing the small intestine, which can be up to 7m long, is indeed a daunting task.
  • OGD to reveal duodenal lesion also for D2 biopsy. (for celiac disease, tropical sprue, whipple disease, abetalipoproteinemia etc)
  • Enteroscopy for enteropathy and jejunal aspirate and culture for bacterial overgrowth.
  • Colonoscopy is helpful in colonic or ileal lesion.
  • ERCP: MRCP to complement or as an alternative to 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.