I. Malabsorption Syndromes
            • Malabsorption disorders- most harmful to nutrition 
                status and result in:
                 – Nutrient deficiencies
                 – Weight loss
                 – Serious complications
            • Disorders associated with malabsorption
                 – Genetic disorders
                 – Pancreatic disorders
                 – Intestinal disorders
                 – Intestinal infections
                 – Liver disease (bile insufficiency)
                 – Surgeries 
            • Rarely involves single nutrient
            • Treatment of malabsorption disorders (surgery and 
                medications) may also weaken nutritional status
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       Nutrition & Diet Therapy (7  Edition)
       Malabsorption Syndromes cont’d
    • Fat malabsorption
         – Causes                                     – Consequences: losses of food 
               • Illness that interferes                 energy, essential fatty acids, 
                 with production or                      fat-soluble vitamins, some 
                 secretion of bile (severe               minerals
                 liver disease) or                         • Weight loss
                 pancreatic lipase                         • Deficiencies of fat-soluble 
                 (pancreatitis, cystic                       vitamins
                 fibrosis)
               • Damage to intestinal                      • Formation of soaps by some 
                 mucosa (inflammatory                        minerals & unabsorbed fatty 
                 disorders or radiation                      acids
                 treatments)                               • Bone loss from calcium 
               • Motility disorders causing                  deficiency
                 rapid gastric emptying or                 • Increased risk of kidney 
                 intestinal transit                          stones (Ca oxalates)
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       Nutrition & Diet Therapy (7  Edition)
       •Fat malabsorption (con’t)
            – Dietary adjustments: fat-restricted diet
                 •Relief of abdominal symptoms (diarrhea & 
                    flatulence)
                 •Minimize loss of vitamins & minerals
                 •Fats should not be restricted more than 
                    necessary 
                 •Alternative source of dietary fat: medium-
                    chain triglycerides (MCT)
                                                                      MCT
                                                  Triglycerides with fatty acids that do 
                                                      not require digestion;  can be 
                                                     absorbed without lipase or bile
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       Nutrition & Diet Therapy (7  Edition)
       Malabsorption Syndromes cont’d
       • Bacterial overgrowth
            – Gastric acid & peristalsis protect stomach & 
               small intestine from bacterial overgrowth
            – When overgrowth does occur, disrupts fat 
               digestion & absorption
            – Eventually results in deficiencies of fat-soluble 
               vitamins
            – Bacteria compete with vitamin B12, impairing 
               its absorption
            – Symptoms: chronic diarrhea, abdominal 
               discomfort, bloating, weakness, weight loss
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       Nutrition & Diet Therapy (7  Edition)