ISSN 2398-2969      

Maldigestion

icanis
Contributor(s):

Ken Harkin

James Simpson


Introduction

  • May be congenital or acquired.
  • Cause: lack of digestive enzymes and/or bile acids.
  • Signs: small intestinal diarrhea Diarrhea: chronic and, sometimes, colitis Colitis: overview.
  • Diagnosis: signs, specific laboratory tests, fecal examination.
  • Treatment: supplementation of appropriate enzymes if possible, dietary modification.
  • Prognosis: may be good - dependent on specific etiology.

Pathogenesis

Etiology

Specific

Pathophysiology

  • Exocrine pancreatic insufficiency Exocrine pancreatic insufficiency → reduction in the production of digestive enzymes → impaired digestion of carbohydrate, fat and protein → osmotic diarrhea → bacterial metabolism of undigested fat and protein → hydroxy fatty acids → act as secretagogues and also may cause inflammation of colon.
  • Brush border disease Brush border membrane disease → reduced activity of disaccharidases and dipeptidases → impaired digestion of carbohydrate and protein.
  • Bile acid deficiency Bile acid deficiency → reduced emulsification of fats → impaired fat digestion.

Timecourse

  • Weeks to months.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

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