Felis ISSN 2398-2950

Maldigestion

Contributor(s): Ed Hall, Philip K Nicholls, Kenneth Simpson

Introduction

  • Cause: lack of digestive enzymes or bile acids, eg exocrine pancreatic insufficiency, intestinal disease.
  • Signs: small intestinal diarrhea, sometimes colitis Diarrhea: dietary.
  • Diagnosis: signs, laboratory tests.
  • Treatment: supplementation of deficient enzymes if possible, dietary manipulation.
  • Prognosis: can be good - depends on etiology.

Pathogenesis

Etiology

Pathophysiology

  • Exocrine pancreatic insufficiency   →   reduction in digestive enzymes in duodenum   →   impaired digestion of carbohydrate, fat and protein   →   osmotic diarrhea   →   bacterial metabolism of undigested fat and protein   →   hydroxylated fatty acids   →   act as secretagogues and also may cause inflammation of colon.
  • Brush border disease   →   reduced activity of lactase and dipeptidases   →   impaired digestion of carbohydrate and protein. Usually secondary to intestinal disease and causes malabsorption.
  • Bile acid deficiency   →   reduced emulsification of fats   →   impaired fat digestion.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers


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