תת-ספיגה במערכת העיכול

What are the symptoms of gastrointestinal malabsorption?

There may be no symptoms if the malabsorption is mild and has not continued for very long. More severe or persistent malabsorption may lead to:

Tiredness (fatigue)

This is because of a lack of energy as you are not absorbing nutrients and essential vitamins and minerals from food.

ירידה במשקל

If you can't absorb enough energy (calories) from your food then this will cause you to lose weight (and may cause poor growth in children).

שלשול מתמשך (כרוני)

This is a common symptom of persistent malabsorption.

Pale, bulky and smelly stools (steatorrhoea)

This is because there is excessive fat in the stools and they become pale, bulky and very smelly. Fatty stools float and are difficult to flush away. They often leave a greasy rim around the pan.

Intestinal malabsorption may also cause:

• חוסר בברזל ו iron-deficiency anaemia.

• חוסר בחומצה פולית.

• חוסר בוויטמין B12.

• Abnormal bleeding, caused by low vitamin K.

• Vitamin D deficiency including rickets and osteomalacia.

• בצקת, which occurs because of insufficient protein and calories absorbed into the body.

There may also be other symptoms due to the particular underlying condition that is causing the malabsorption.

What are the causes of gastrointestinal malabsorption?

The most common causes in the UK are מחלת צליאק, מחלת קרוהן and chronic pancreatitis. However, the malabsorption of simple carbohydrates affects about 1 in 4 people in Europe. Some diseases associated with malabsorption are found more often in some families - for example, coeliac disease, Crohn's disease, סיסטיק פיברוזיס and lactose intolerance.

The causes of gastrointestinal malabsorption include:

Problems with absorbing food from the gut (bowel) into your body

• מחלת צליאק - a long-term disease that mostly affects the small intestine.

• אי סבילות ללקטוז.

• אלרגיה לחלבון חלב פרה.

• אי סבילות לחלב סויה.

• Fructose intolerance.

• Infection - for example, intestinal tuberculosis, שלשול של מטיילים.

• Immune deficiency - למשל, זיהום HIV.

• Pancreatic insufficiency - for example, סיסטיק פיברוזיס, דלקת לבלב כרונית, סרטן הלבלב.

• Bile salts and acid malabsorption.

גורמים מבניים

Malabsorption may be cause by loss of part of the bowel that is essential to absorb the broken down (digested) food into the body - for example:

• Removal of the stomach or part of the bowel after a stomach or bowel operation.

• מחלת קרוהן.

Causes outside the bowel

דוגמאות כוללות:

• א בלוטת תריס פעילה יתר על המידה (היפרתירואידיזם).

• Eating disorders: אנורקסיה נרבוזה, bulimia nervosa.

אילו בדיקות נדרשות?

Initial tests will include בדיקות דם ו stool tests. Further tests may include an abdominal בדיקת אולטרסאונד, barium studies ו סריקת טומוגרפיה ממוחשבת (CT) או סריקת דימות תהודה מגנטית (MRI). Any further tests will depend on the likely underlying cause of the intestinal malabsorption.

What are the treatments for gastrointestinal malabsorption?

The treatment will mainly depend on the underlying cause of the malabsorption. However, treatment will also be needed to increase the amount of essential nutrients in the body, including carbohydrates, proteins, fats, minerals and fat-soluble vitamins (nutritional support).