Malabsorption other diagnostic studies

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Malabsorption

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Overview

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

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 visualise 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, A-b-lipoproteinemia etc.)
  • Enteroscopy for enteropathy and jejunal aspirate and culture for bacterial overgrowth
  • Colonoscopy is helpful in colonic or ileal lesion.

Other Investigations

  • Radio isotope tests e.g. 75SeHCAT, 95mTc to exclude terminal ileal disease.
  • Sugar probes or sub 51Cr-EDTA to determine intestinal permeability[1].
  • 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

References