Malabsorption syndrome

Digestion | December 24, 2017 | Author: Naturopath

Digestion

Malabsorption syndrome

When you eat a nutritious meal, you would expect to reap the benefits by providing your body with a range of vitamins and minerals. In people with malabsorption syndrome, they are unable digest and absorb nutrients adequately—resulting in nutritional deficiencies and other complications. People with celiac disease and lactose intolerance are prone to suffering malabsorption – with symptoms including bloating, diarrhoea and weight loss. Trying to find a solution to these problems involves supporting the different layers and organs involved in digestion.

What causes malabsorption?

Malabsorption may be short-lived or long-term. The risk factors in malabsorption syndrome include:What causes malabsorption?

  • Cystic fibrosis and diseases that affect the pancreas
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  • Lactose intolerance or other enzyme-related conditions
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  • Coeliac disease (gluten in the diet triggers the immune system to attack the body)
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  • Inflammatory bowel diseases
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  • Infection (parasites, viruses, yeast or bacteria)
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Symptoms of malabsorption

  • Gas and bloating
  • Frequent diarrhoea
  • Foul smelling and loose stools that are hard to flush
  • Weight loss
  • Scaly skin rashes
  • Fatigue

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Complications include greater risk of infection, bone fractures and slower growth and weight gain in children

Trying to find a solution to these problems involves supporting the different layers and organs involved in digestion.

The functional layers of the gut

There are six key functional components of the gut which will be affected in a person with malabsorption issues. These Include:

  • Diet 
  • Enzymes
  • Bacteria
  • Barrier
  • Immune
  • Enteric nervous system

‚ÄčDysfunction in a layer may be identified by certain signs and symptoms.

The functional layers of the gutDiet

The diet includes all ingested food and drink which provide nutrition to the body.

The function of the digestive system is to break down food (digest), absorb nutrients in the small intestine and excrete left-over waste products.

In malabsorption the emphasis is on an extremely nutritious diet which removes processed foods and possible food allergens.
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Questions to ask yourself

  • Are your symptoms worse after eating certain foods?
  • Are they worse after eating?

Treatment suggestions

If you answered yes to any of these questions, further testing involving IgE or IgG food tests may help to identify certain foods which could be causing digestive problems and malabsorption. If suspected by your doctor or naturopath, testing for coeliac disease may be conducted. Sometimes completing an elimination diet may give more information—where common allergenic/intolerant foods are removed from the diet and then challenged one at a time to see if there is any reaction.

Some people may benefit from following a specific dietary plan. This may include low FODMAP, dairy free or gluten free diet. To determine what diet would be best for you speak to your naturopath/nutritionist.
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Enzymes

EnzymesThe second area to consider in malabsorption syndrome is disruption to the production of digestive enzymes. This includes the release of pancreatic and intestinal enzymes, hydrochloric acid and bile secretion. These help to break down food to smaller particles for absorption across the intestinal barrier.

Questions to ask yourself

  • Do you get full quickly?
  • Do you get bloated after meals?
  • Do you experience excessive belching?
  • Do you have undigested food or fat in stools?
  • Do you have food sensitivities i.e. dairy?

Treatment suggestions

If you suffer from any of the above, supplementing with vegetarian digestive enzymes and hydrochloric acid can help support breaking down foods and absorbing nutrients. Gentian, dandelion root, globe artichoke and ginger are herbs that stimulate digestion and provide support to specific organs involved in the process. Bitter foods may also be helpful and include rocket, dandelion greens, kale and diluted fresh lemon juice.
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Bacteria

Our intestinal microbiome plays an enormous role in health and disease.

If impaired it can have dire consequences for our digestive system—resulting in impaired immune function, nutrition and intestinal barrier function.

Healthy bacteria promote tight junction complexes in the intestinal wall and protect against leaky gut syndrome.

Questions to ask yourself

  • Do you have a history of antibiotic use?
  • Have you travelled overseas recently?
  • Do you suffer from constipation or diarrhoea?
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Treatment

Probiotics and elements that promote their growth (prebiotics) may be useful here. They help to reduce pathogens in the gut and influence many aspects of gut and immune health. When selecting a probiotic, choose a clinically trialled strain that is specific for your health needs. Fermented foods, increasing fibre and adopting a healthy diet will also help to improve the composition of gut microbial flora.

Barrier

A barrier exists between the gut lumen, which is the hollow inside of the digestive tract, and the host. The function of this barrier is to selectively allow substances to pass through and to keep out substances that are potentially dangerous.

Questions to ask yourself

  • Do experience gut pain?
  • Do you have ulcers or gastritis?
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  • Do you have food sensitivities?
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  • Do you suffer from frequent infections?

Treatment

There are specific herbs and nutrients that help improve barrier function by reducing inflammation and promoting repair.

Suggested nutrients include:

  • boswellia
  • aloe vera
  • slippery elm
  • zinc
  • glutamine.

They may be particularly helpful for inflammatory bowel diseases such as ulcerative colitis and Crohn’s disease which can lead to malabsorption.

Immune

The majority of the immune system is associated with the digestive tract to keep us safe from invading pathogens. The activity of the immune system has a profound effect on the health of our digestive system. A classic example of dysfunction in this area is coeliac disease—where the immune system responds to gluten and causes severe digestive symptoms as well as malabsorption.

Questions to ask yourself

  • Do you have food sensitivities?
  • Do you suffer from any autoimmune conditions or allergies?
  • Do you have a family history of autoimmunity, eczema, hay fever or asthma?

Treatment

Depending on your needs, treatment may be focused on bringing balance to the immune system. Quercetin, vitamin C, vitamin D, albizzia, perilla and zinc are anti-allergy nutrients used to dampen an overactive immune system. Anti-inflammatory nutrients such as omega-3 essential fatty acids, turmeric and bromelain may be indicated too.

Enteric nervous systemEnteric nervous system

The nervous system network of the gastrointestinal system is the final critical component of these layers.

Aberrations in the enteric nervous system are a hallmark of the heightened pain perception often experienced in irritable bowel syndrome.

Questions to ask yourself?

  • Do you suffer from constipation or diarrhoea?
  • Do you have chronic gut pain?
  • Are your symptoms worse for stress?
  • Do you suffer from stress, anxiety or depression?
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Treatment

There is a connection between our brain and gut—so if we are stressed or depressed this can affect the way our gut works. Magnesium, B vitamins and herbs which promote relaxation such as valerian or passionflower may help to improve mood and reduce anxiety. Finding ways to relax through exercise, yoga or meditation can reduce pain levels and stress.
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Putting it all together

  • Certain disorders such as cystic fibrosis, inflammatory bowel disease and infection can lead to malabsorption
  • Improving the layers of the gut can help restore function and improve absorption of nutrients
  • The focus in malabsorption is to eat a nutritious diet

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References

http://www.merckmanuals.com/home/digestive-disorders/malabsorption/overview-of-malabsorption

https://www.webmd.com/digestive-disorders/malabsorption-syndrome#1

https://opentextbc.ca/anatomyandphysiology/chapter/23-1-overview-of-the-digestive-system/

Siddiqui ZOsayande AS. Selected disorders of malabsorption. Prim Care. 2011 Sep;38(3):395-414; vii

https://www.ncbi.nlm.nih.gov/pubmed/21872088

van der Heide F. Acquired causes of intestinal malabsorption. Best Pract Res Clin Gastroenterol. 2016 Apr;30(2):213-24

https://www.ncbi.nlm.nih.gov/pubmed/27086886

De Palma G, et al. The microbiota-gut-brain axis in functional gastrointestinal disorders. Gut Microbes. 2014 May-Jun;5(3):419-29

https://www.ncbi.nlm.nih.gov/pubmed/24921926

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