Approaching the patient with chronic malabsorption syndrome

G. C. Harewood, Joseph A Murray

Research output: Contribution to journalReview article

8 Citations (Scopus)

Abstract

The causes of chronic malabsorption may be categorized as decreased intestinal absorption, most commonly caused by celiac sprue; or maldigestion caused by pancreatic insufficiency. The initial step in the evaluation of these patients should include stool studies to confirm fat malabsorption. If fat malabsorption is confirmed, endoscopy with small-bowel biopsies and aspirates for bacterial culture usually follows. A normal endoscopic examination should lead to assessment of pancreatic function. In the setting of normal pancreatic function and the absence of bile acid deficiency, a barium radiograph of the small bowel should be made, looking for anatomical abnormalities. Celiac sprue is an intolerance to gluten caused by a combination of genetic, environmental, and immunologic factors. It classically causes malabsorption. However, it is likely that many patients who exhibit only minor manifestations of the disease go unrecognized and untreated. A presumed diagnosis of celiac sprue is confirmed after a clinical and endoscopic response to a gluten-free diet. Serological markers are available with high degrees of sensitivity and specificity, but duodenal biopsy remains the gold standard for diagnosis. A minority of patients are unresponsive to a gluten-free diet, and intestinal lymphoma should be suspected in these cases.

Original languageEnglish (US)
Pages (from-to)138-144
Number of pages7
JournalSeminars in Gastrointestinal Disease
Volume10
Issue number4
StatePublished - 1999

Fingerprint

Malabsorption Syndromes
Celiac Disease
Gluten-Free Diet
Fats
Exocrine Pancreatic Insufficiency
Biopsy
Glutens
Intestinal Absorption
Immunologic Factors
Barium
Bile Acids and Salts
Endoscopy
Lymphoma
Sensitivity and Specificity

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Approaching the patient with chronic malabsorption syndrome. / Harewood, G. C.; Murray, Joseph A.

In: Seminars in Gastrointestinal Disease, Vol. 10, No. 4, 1999, p. 138-144.

Research output: Contribution to journalReview article

@article{ac1a1610d57d4f0790c990bac90799f3,
title = "Approaching the patient with chronic malabsorption syndrome",
abstract = "The causes of chronic malabsorption may be categorized as decreased intestinal absorption, most commonly caused by celiac sprue; or maldigestion caused by pancreatic insufficiency. The initial step in the evaluation of these patients should include stool studies to confirm fat malabsorption. If fat malabsorption is confirmed, endoscopy with small-bowel biopsies and aspirates for bacterial culture usually follows. A normal endoscopic examination should lead to assessment of pancreatic function. In the setting of normal pancreatic function and the absence of bile acid deficiency, a barium radiograph of the small bowel should be made, looking for anatomical abnormalities. Celiac sprue is an intolerance to gluten caused by a combination of genetic, environmental, and immunologic factors. It classically causes malabsorption. However, it is likely that many patients who exhibit only minor manifestations of the disease go unrecognized and untreated. A presumed diagnosis of celiac sprue is confirmed after a clinical and endoscopic response to a gluten-free diet. Serological markers are available with high degrees of sensitivity and specificity, but duodenal biopsy remains the gold standard for diagnosis. A minority of patients are unresponsive to a gluten-free diet, and intestinal lymphoma should be suspected in these cases.",
author = "Harewood, {G. C.} and Murray, {Joseph A}",
year = "1999",
language = "English (US)",
volume = "10",
pages = "138--144",
journal = "Seminars in Gastrointestinal Disease",
issn = "1049-5118",
publisher = "W.B. Saunders Ltd",
number = "4",

}

TY - JOUR

T1 - Approaching the patient with chronic malabsorption syndrome

AU - Harewood, G. C.

AU - Murray, Joseph A

PY - 1999

Y1 - 1999

N2 - The causes of chronic malabsorption may be categorized as decreased intestinal absorption, most commonly caused by celiac sprue; or maldigestion caused by pancreatic insufficiency. The initial step in the evaluation of these patients should include stool studies to confirm fat malabsorption. If fat malabsorption is confirmed, endoscopy with small-bowel biopsies and aspirates for bacterial culture usually follows. A normal endoscopic examination should lead to assessment of pancreatic function. In the setting of normal pancreatic function and the absence of bile acid deficiency, a barium radiograph of the small bowel should be made, looking for anatomical abnormalities. Celiac sprue is an intolerance to gluten caused by a combination of genetic, environmental, and immunologic factors. It classically causes malabsorption. However, it is likely that many patients who exhibit only minor manifestations of the disease go unrecognized and untreated. A presumed diagnosis of celiac sprue is confirmed after a clinical and endoscopic response to a gluten-free diet. Serological markers are available with high degrees of sensitivity and specificity, but duodenal biopsy remains the gold standard for diagnosis. A minority of patients are unresponsive to a gluten-free diet, and intestinal lymphoma should be suspected in these cases.

AB - The causes of chronic malabsorption may be categorized as decreased intestinal absorption, most commonly caused by celiac sprue; or maldigestion caused by pancreatic insufficiency. The initial step in the evaluation of these patients should include stool studies to confirm fat malabsorption. If fat malabsorption is confirmed, endoscopy with small-bowel biopsies and aspirates for bacterial culture usually follows. A normal endoscopic examination should lead to assessment of pancreatic function. In the setting of normal pancreatic function and the absence of bile acid deficiency, a barium radiograph of the small bowel should be made, looking for anatomical abnormalities. Celiac sprue is an intolerance to gluten caused by a combination of genetic, environmental, and immunologic factors. It classically causes malabsorption. However, it is likely that many patients who exhibit only minor manifestations of the disease go unrecognized and untreated. A presumed diagnosis of celiac sprue is confirmed after a clinical and endoscopic response to a gluten-free diet. Serological markers are available with high degrees of sensitivity and specificity, but duodenal biopsy remains the gold standard for diagnosis. A minority of patients are unresponsive to a gluten-free diet, and intestinal lymphoma should be suspected in these cases.

UR - http://www.scopus.com/inward/record.url?scp=0032728183&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032728183&partnerID=8YFLogxK

M3 - Review article

C2 - 10548407

AN - SCOPUS:0032728183

VL - 10

SP - 138

EP - 144

JO - Seminars in Gastrointestinal Disease

JF - Seminars in Gastrointestinal Disease

SN - 1049-5118

IS - 4

ER -