| disease | Malabsorption Syndrome of the Small Intestine |
A clinical syndrome caused by various factors leading to impaired digestion and absorption in the small intestine, resulting in the inability to properly absorb nutrients, which are then excreted in feces, causing nutritional deficiencies, also known as malabsorption syndrome. Since most patients have diarrhea, with loose and voluminous stools containing excessive fat, it is also referred to as steatorrhea.
bubble_chart Diagnosis
Medical history and symptoms:
Frequency of diarrhea, duration, appearance and quantity of stool. 80-97% of patients experience diarrhea, typically presenting as steatorrhea with pale, voluminous, greasy, or frothy stools, often foul-smelling. The frequency of bowel movements ranges from several to over ten times a day, sometimes intermittent. Abdominal pain, abdominal distension, and fullness are rare. Additionally, inquiries should be made regarding symptoms of malnutrition such as weight loss, lack of strength, hand and foot convulsions, paresthesia, stomatitis, dryness of the corneal membrane, night blindness, edema, etc. Previous examinations and treatments also aid in diagnosis.
Physical examination findings:
Patients may exhibit weight loss, mild abdominal tenderness, peripheral paresthesia, stomatitis or ulcers, pellagra-like pigmentation, edema, spoon nails, muscle tenderness, clubbing of fingers (toes), and other signs.
Auxiliary examinations:
Macrocytic anemia is common, with reduced serum electrolytes, plasma albumin, cholesterol, and even folate and vitamin B12 levels. Fecal fat quantification >6g/d, D-xylose absorption test. <3g，維生素B12吸收試驗<8～10%。腸內菌群失調時，14C－甘氨膽酸呼氣試驗陽性。胃腸鋇餐注意腸管是否擴張、積液及鋇劑沉積"臘管"徵，內鏡檢查觀察小腸絨毛，皺襞的變化。
Differential diagnosis should be considered for diarrhea caused by other reasons.
Substitute therapy is an important measure in treating such diseases. It is best to use intravenous hyperalimentation to replenish lost water, electrolytes, various nutrients, and vitamins. If necessary, intravenous albumin or blood transfusion may be administered. There are also specific measures tailored to the particular disease cause. 1. **Gluten-induced enteropathy**: - Zinc sulfate 200mg, orally, 3 times/day. - Vitamin K4, 8mg, IM once/day. - 10% calcium gluconate 10ml, IV. - For severe cases, hydrocortisone IV drip or oral prednisone may be used. 2. **Tropical sprue**: - Tetracycline 250–500mg, 4 times/day for one month, then reduced to twice/day for six months. 3. **Whipple’s disease**: - Procaine penicillin G 1.2 million units + streptomycin 1.0g, IM once/day for two weeks, followed by tetracycline 0.5g, orally, 4 times/day for several months.
