Mal absoprtion syndrome

Mal absorption syndrome is a group of disorders marked by
Indigestion
Excessive nutrients loss in stools
Abnormal absorption of dietary constituents
It is a state arising from abnormality in absorption of food nutrients across the gastrointestinal tract.

Impairment can be of single or multiple nutrients depending on the abnormality. This may lead to malnutrition and a variety of anemia.

Malabsorption constitutes the pathological interference with the normal physiological sequence of body.

1. MAL ABSORPTION
SYNDROME
By
Mr. Ravi Rai Dangi
Assistant Professor
Fellowship in Neonatal Nursing
MSc. Child Health Nursing

2. DEFINITION
Malabsorptionsyndromeisagroupofdisordersmarkedby
Indigestion
Excessivenutrientslossinstools
Abnormalabsorptionofdietaryconstituents

3. Itisastatearisingfromabnormalityinabsorptionoffood
nutrientsacrossthegastrointestinaltract.
Impairmentcanbeofsingleormultiplenutrients
dependingontheabnormality.Thismayleadto
malnutritionandavarietyofanemia.
Malabsorptionconstitutesthepathologicalinterference
withthenormalphysiologicalsequenceofbody.

4. CAUSES:
Bile salt insufficiency:
Obstructive jaundice
Bacterial overgrowth
Infection
Acuteinfectiousenteritis
Parasiticinfections,suchasgiardia,orhelminthiasis

5. Pancreaticdisease
Chronicpancreatitis
Carcinomaofpancreas

6. Structural defects:
Inflammatory bowel diseases commonly: Crohn's
Disease

7. Gastrectomy

8. Gastro-jejunostomy

9. Short bowel syndrome.

10. Lymphatic obstruction
Intestinal lymphoma
Intestinal Tuberculosis

11. Itisapathologicdilationof
lymphvessels.Whenitoccurs
intheintestinesofdogs,and
morerarelyhumans,itcauses
adiseaseknownas"intestinal
lymphangiectasis"
Lymphangiectasis

12. PEM
Irondeficiencyanemia
SevereSteatorrheaduetocysticfibrosis,celiac
disease

13. CLINICAL MANIFESTATION
Chronicdiarrhea
Abdominaldistension
Failuretothrive
Flatulence
Anorexia

14. Fatigue
Weightloss
Directconsequenceofmalabsorptionwhichleadsto
malnutritionandgrowthfailure
Malabsorptionsyndromeandchronicdiarrheais
manifestedwiththreemajorcategories,theseare-impaired
digestion,intestinalmalabsorptionandcarbohydrate
malabsorption.

15. Impaired Digestion
Itoccursduetoexocrinepancreaticinsufficiencyalso
resultsinchronicdiarrheaandmalabsorption.
Duetocysticfibrosis,lipasedeficiencyandcrohn’s
disease.
Itismanifestedasfrequentloosepasty,greasystoolswith
undigestedfatandoffensivecheesysmell.

16. Intestinal Malabsorption
presentedwithchronicdiarrheaaslooseorliquidstool.
Thesepatientshavesteatorrhea
Thisconditionisusuallyassociatedwithceliacdisease,
foodproteinsensitivity,giardiasis,immunodeficiency,
malnutritionandbacterialovergrowth

17. Carbohydrate Malabsorption
Itmaybepresentedaschronicdiarrheadueto
fermentation.

18. INVESTIGATION
Historyofillness
Physicalexamination
Routinestoolexamination

19. Fecalfatstudiesforsteatorrhea
D-Xylosetest(performedtodiagnoseconditionsthatpresent
withmalabsorptionoftheproximalsmallintestine)
Intestinalbiopsy
Radiologytest-bariummealstudytodetectstructuraldefect

20. Specifictest-like
Sweatchloridetestforcysticfibrosis(sweattest
measurestheconcentrationofchloridethatisexcreted
insweat)
Bloodserologytestforceliacdisease,
Hydrogenbreathanalysisforcarbohydrate
malabsorption
Lactosetolerancetest

21. MANAGEMENT
Replacementofelectrolytesandfluidbyparental
administration.
Adequatenutritionintakeconsideringthespecificdefect.
Controlthediarrhea
Dietarymodificationisimportantinsomeconditions:
Gluten-freedietincoeliacdisease.
Lactoseavoidanceinlactoseintolerance.

22. AntibiotictherapywilltreatSmallBowelBacterial
overgrowth.
Incysticfibrosis,thedietshouldbeplannedwithfood
itemsrichinproteinandsugar.
Forcarbohydratemalabsorptiongiveglucoseand
galactosefreediet.
Pancreaticsupplements,antacidandantihistamineare
essential.

23. NURSING MANAGEMENT

24. Assessment
Dailyintakeoutput
Dailyweight
Vitalsigns
Serumelectrolyte
GIFunction
CharacteristicofStool

25. Nursing Diagnosis
Diarrhearelatedtoindigestionsecondarytomal
absorption
Imbalancednutritionlessthanbodyrequirementrelated
toindigestionsecondarytodiarrhea.
Fluidandelectrolyteimbalancerelatedtoindigestion
secondarytomalabsorption

26. Knowledgedeficitrelatedtohospitalizationandmal
absorptiondisease
Fearandanxietyrelatedtohospitalization(inparentsand
child)

27. Nursing Intervention
Improvementofnutritionalstatusbyappropriatediet
planningandsupplementationofdeficientnutrition.
Restorationoffluidandelectrolytebalancebyoraland
parenteraltherapy
Continuousmonitoringandrecordingofpatient’s
condition

28. Reliefofpainbymedicationandanti-diarrhealagentsfor
diarrheaasprescribedbydoctor
Maintenanceofskinintegrityspeciallyperinealarea
Healtheducationtoparentsaboutgeneralcleanliness,
nutrition,hydration,dangersign,homecareandfollow-up,
fornecessarymedicalhelp.
Reliefoffearandanxietyaboutlongtermillnessand
hospitalizationbyappropriateexplanation,reassurance
andnecessarysupport.

29. Bibliography
Books
Wongs, EssentailOf Pediatric Nursing , Elsevier
Publisher, 10
th
Edition , Page no 732-733
Paruldata, Pediatric Nursing, 3
rd
edition, Jaypee
Publisher, page no 279-280
Reference
https://www.healthline.com/health/malabsorption
https://nurseslabs.com/diarrhea/#nursing-assessment