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==Other Diagnostic Studies==
==Other Diagnostic Studies==
===Radiological Studies===
*[[Barium follow through]] is useful in delineating [[small intestine|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.
===Interventional Studies===
===Interventional Studies===


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*Endoscopy is frequently undertaken, but to visualize small intestine which can be up to 7m long is indeed a daunting task.
*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.)
**[[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
**[[Enteroscopy]] for enteropathy and jejunal aspirate and culture for bacterial overgrowth.
: (c) [[Colonoscopy]] is helpful in colonic or ileal lesion.
**[[Colonoscopy]] is helpful in colonic or ileal lesion.
*[[ERCP]]: [[MRCP]] to complement or as an alternative to [[ERCP]]
**[[ERCP]]: [[MRCP]] to complement or as an alternative to [[ERCP]]


===Other Investigations===
===Other Investigations===

Revision as of 18:41, 27 March 2013

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

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.
    • 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.
    • 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[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

  1. ↑ Bai J (1998). "Malabsorption syndromes". Digestion. 59 (5): 530–46. PMID 9705537.
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