Malabsorption is a common condition that occurs when inflammation, disease, or injury prevents the small intestine from absorbing enough of the nutrients it receives. To diagnose malabsorption, consider whether you are experiencing the right symptoms or not, then go to a doctor to diagnose the underlying cause and determine the best treatment.
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Method 1 of 3: Part One: Recognizing the Symptoms
Step 1. Know the most common symptoms
The exact symptoms may vary depending on the nutrient that is failing to be absorbed by the body or the main condition causing the problem, but there are some symptoms that are common to most cases of malabsorption.
- Changes in weight and growth are fairly common symptoms. Insufficient calorie absorption leads to weight loss and stunted growth.
- Gastrointestinal problems are also common. Chronic diarrhea is one of the most common symptoms, but you can also experience bloating. There may also be excess fat in the stool, which causes a change in the color and consistency of the stool.
- Fatigue, weakness, and muscle cramps may also occur.
Step 2. Know which symptoms indicate a deficiency of healthy fats
The body needs to absorb healthy fats in regular amounts. If your intestines can't absorb the fat you eat, you can usually tell by observing your stool.
In particular, watch for stools that are brightly colored, soft, fat, and have an abnormally bad odor. This stool may also be difficult to flush or may stick to the sides of the toilet bowl. This is the biggest indication of fat deficiency
Step 3. Look for signs of protein malabsorption
In addition to the common symptoms associated with malabsorption, protein deficiency can also cause fluid retention and hair problems.
- You may have edema, swelling of your feet, ankles, or soles caused by fluid retention.
- Hair may become abnormally dry and fall out more than usual.
Step 4. Determine if there is a problem with the sugar
Most of the symptoms that are mainly caused by sugar deficiency are directly related to the digestive system.
- If you experience abnormal bloating or flatulence, it could be an indication of a sugar deficiency.
- Explosive diarrhea is another common symptom.
Step 5. Learn which signs point to vitamin deficiency
Vitamin deficiency has the widest variety of symptoms, but there are still some common signs to look out for.
- You are likely to experience anemia, low blood pressure, and weight loss.
- You may also experience abnormal fatigue, weakness, pale skin, difficulty breathing, unusual appetites, hair loss, lightheadedness, constipation, heart palpitations, depression, poor concentration, and tingling or numbness in the joints.
Step 6. Ask yourself if you have any risk factors
Although malabsorption can occur even in the absence of specific co-occurring risk factors, the presence of one or more risk factors increases the likelihood of a malabsorption problem.
- Excessive consumption of alcohol, antibiotics, laxatives, and mineral oil can put you at risk.
- Recent bowel surgery is another major risk factor.
- A family history of malabsorption also puts you at a higher risk.
- If you recently traveled to Southeast Asia, the Caribbean Islands, India, or another country where intestinal parasites are common, you may have been infected with a parasite that causes malabsorption.
Method 2 of 3: Part Two: Getting an Official Diagnosis
Step 1. Identify common causes
There are many different conditions that can cause malabsorption. Your doctor will evaluate the results of your laboratory tests to determine which condition is the most likely cause.
- Diseases and disorders that can cause malabsorption include lactose intolerance, celiac disease, intestinal parasites, HIV/AIDS, cancer, Whipple's disease, bacterial infections, tropical thrush, scleroderma, intestinal lymphoma, Crohn's disease, and cystic fibrosis.
- In addition, poor digestion can be caused by bacterial overgrowth syndrome, gastric resection, impaired pancreatic function, gastric acid overproduction, short bowel syndrome, and liver disease.
- Intestinal damage caused by radiation therapy, antibiotics, and certain other medications can also cause malabsorption.
- Surgical operations that affect the intestines or digestive system can also have an impact on absorption. Any surgery that removes part of the intestines can cause malabsorption, and surgical treatment for obesity can also be a cause.
Step 2. Schedule a check-up with your doctor
If you suspect that you have a malabsorption problem, schedule an appointment with your doctor as soon as possible. Your doctor will do laboratory tests to determine if malabsorption is causing your symptoms. Once malabsorption is diagnosed, the doctor will perform further tests to determine the underlying cause.
- List your symptoms, including those that you believe are caused by malabsorption or that may seem unrelated.
- You should also prepare a family medical history for your doctor to see. Because some malabsorption diseases are genetic, having a family history of the disorder can make it easier for your doctor to diagnose your current condition.
Step 3. Plan a stool test
You will almost always need to provide a stool sample for testing when malabsorption is suspected.
- The stool sample will be tested for excess fat because in many cases malabsorption results in poor fat absorption. You will be asked to consume excess fat for one to three days, and samples will be collected over that time period.
- The sample may also be tested for bacteria and parasites.
Step 4. Do a blood test
Blood tests are used to analyze and find specific nutritional deficiencies, including anemia, low protein levels, vitamin deficiencies, and mineral deficiencies.
- In many cases, blood tests can also be used to make certain diagnoses.
- Your doctor will likely look at plasma viscosity, vitamin B12 levels, red blood cell folate levels, iron levels, blood clotting abilities, calcium levels, antibodies, and serum magnesium levels.
Step 5. Prepare for the imaging exam
The doctor may use an endoscope or a series of imaging tests to look inside the body for internal signs of damage or malabsorption.
- An abdominal ultrasound may be used to diagnose problems with the gallbladder, liver, pancreas, intestinal wall, or lymph nodes.
- You may be asked to drink a barium solution which will allow the technician to see structural abnormalities more clearly.
- An X-ray or CT-scan of the abdomen may be performed, which allows the doctor to see a larger image showing the abdominal organs and the overall structure of the abdomen.
Step 6. Learn about the xylose absorption test
This test evaluates the integrity of the intestinal wall and its ability to absorb nutrients.
- You will be asked to drink a xylose drink, which contains a sugar that will be absorbed along the intestinal wall.
- After drinking the solution, urine and blood tests will be performed over a period of several hours.
- Xylose should appear in the blood and urine. If the level of xylose in the blood is low but in the urine is high, there may be a problem with the intestinal wall.
Step 7. Prepare for a pancreatic function test
Although somewhat uncommon, pancreatic function tests are usually performed when the results of the more common tests are inconclusive or if a pancreatic problem is suspected.
- In one pancreatic function test, a tube inserted through the nose or mouth is positioned at the opening of the pancreatic duct. The secretions are collected, and the enzyme and bicarbonate secretions are analyzed.
- In another pancreatic function test, you will be asked to take a chemical called bentiromide. The pancreas is supposed to break down these chemicals and absorb the products of that breakdown into the urine. Urine will be collected and analyzed to determine whether natural processes are working as they should or not.
Step 8. Learn about the hydrogen breath test
The breath hydrogen test is commonly used to diagnose lactose intolerance and similar sugar-based malabsorption conditions.
- During the test, you will be asked to breathe into a special collection container.
- You will then be asked to drink a solution of lactose, glucose, or another sugar.
- Additional breath samples from you will be collected at 30-minute intervals and examined for bacterial and hydrogen overgrowth. Abnormal hydrogen levels indicate an abnormality.
Step 9. Note that a biopsy may be required
If a less invasive test indicates a possible problem with the bowel wall, the doctor may take a sample of the bowel wall for further laboratory analysis.
The sample is usually taken during an endoscopy or colonoscopy. If one of these tests has already been scheduled, the doctor may recommend a biopsy even before the results of the less invasive tests are obtained from the laboratory
Method 3 of 3: Part Three: Developing a Treatment Plan
Step 1. Replace previously lost nutrients
Once your doctor can diagnose which nutrients aren't being absorbed, you may be given supplements and fluids to replace those nutrients.
- Hospitalization may be required in severe cases.
- Mild to moderate cases may be treated with oral supplements or short doses of nutrient-rich intravenous fluids.
- Your doctor may also recommend a new, nutrient-dense diet for you to follow. The nutrients that you are currently lacking will likely increase with this diet plan.
Step 2. Work with your doctor to treat the underlying condition
Some causes of malabsorption can be cured. Others are incurable, but can be treated and controlled. However, the specific treatment you'll need will vary depending on the underlying condition causing the malabsorption. So you will need to work with your doctor to determine the best treatment for your specific condition.
- Infections and parasites are usually curable, which can cure malabsorption completely.
- Celiac disease requires you to eliminate gluten from your diet. Pancreatic insufficiency requires long-term use of oral enzymes. Vitamin deficiencies may require long-term use of vitamin supplements.
- Some causes, such as blockage and blind loop syndrome, may require surgical intervention.
