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Differential diagnosis and investigation of malabsorption 

Differential diagnosis and investigation of malabsorption
Differential diagnosis and investigation of malabsorption

Alastair Forbes

, and Victoria Mulcahy

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date: 07 March 2021

Malabsorption is defined as defective mucosal absorption in the intestine, with clinical presentation ranging from diarrhoea or steatorrhoea with massive weight loss, through to abdominal bloating, fatigue, changes in bowel habit, or anaemia. There are many causes, but the commonest in adult life are coeliac disease, Crohn’s disease, and bile salt malabsorption. Simple blood tests may prompt suspicion of malabsorption, will sometimes go a long way to providing a diagnosis, and will guide further investigation with specific tests, for example, serum antibody to tissue transglutaminase (coeliac disease), endoscopic examinations, imaging studies, breath tests, and tests of bile salt absorption. Treatment for malabsorption is directed (where possible) to the underlying cause as specific agents to address the malabsorption itself are lacking. General nutritional support and replacement of individual deficiencies are crucial.

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