Malabsorption other diagnostic studies

Malabsorption
Home
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

• 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.

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: 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.