Insufficient Absorption Syndrome

Insufficient absorption of the syndrome (malabsorption syndrome) is an asymptomatic complex that arises from a disorder of absorption in the small intestine. Often combined with a syndrome of insufficiency of digestion. Distinguish primary and secondary syndrome of insufficiency of absorption.

The cause of the syndrome of insufficiency of absorption - hereditary disorders of the structure of the mucous membrane of the intestinal wall and genetically determined intestinal fermentopathy. The mechanism of development of a secondary syndrome of insufficient absorption is the acquired structural changes in the mucosa of the small intestine. In acute and subacute conditions, disruption of intestinal digestion of food products and accelerated passage of contents through the intestine are of primary importance, with chronic dystrophic and atrophic-sclerotic changes in the intestinal mucosa, shortening and flattening of villi and crypts, a sharp reduction in the number of microvilli, the development of fibrous tissue In the wall of the intestine with a disturbance of the blood flow in it, disturbance of the processes of parietal digestion. All these changes lead to inadequate intake of hydrolyzed products of proteins, fats, carbohydrates, and mineral salts and vitamins through the intestinal wall (see also Apical Dystrophy).

Symptoms, course. Characteristic is the gradual exhaustion of the patient, the breakdown of all kinds of metabolism (protein, fat, vitamin, water-salt), dystrophic changes in internal organs with gradually emerging impairments of their functions, as well as constant steatorrhea, creatorrhea and amylorrhea. Develops hypoproteinemia, mainly due to albumins, hypocholesterolemia, hypocalcemia, mild hypoglycemia. With hypoproteinemia below 40-50 g / l hypoproteinemic edema occurs. Characteristic symptoms of polyhypovitaminosis, osteoporosis, anemia, trophic changes in the skin, nails, progressive muscle atrophy, polyglandular insufficiency, general weakness, in severe cases, mental disorders, acidosis, cachexia.

Laboratory methods allow to determine hypoproteinemia, hypocholesterolemia, hypoglycemia and other disorders as a consequence of insufficient absorption in the intestine.

When coprological research, there is an increased isolation of undigested food substances, as well as products of their enzymatic cleavage. Enterobiopsiya reveals atrophic changes in the mucosa of the proximal parts of the small intestine. To investigate the absorption processes, a variety of special methods are used, the iodocyanin test, samples with D-xylose, galactose, carotene, folic acid, iron absorption test, methods using radiolabelled casein, albumin, oleic acid, methionine, glycine, vitamin B12, Folic acid and other substances.

The course depends on the nature of the underlying disease and the possibility of its cure. In severe incurable cases, the forecast is unfavorable.

Treatment. The main disease is treated. Symptomatic therapy includes parenteral nutrition, administration of vitamins, plasma, protein hydrolysates, glucose solution, nutrient intestinal enemas, correction of electrolyte exchange disorders.

Prevention. Prevention and timely treatment of diseases that occur with the syndrome of insufficient absorption.