ppt on malabsorptions.pptx

Malabsorption syndrome

1. MALABSORPTION SYNDROME PRESENTED BY –RUTUPARNA SATAPATHY

2. DEFINATION It is a state arising from abnormality in absorption of food nutrients across the gastrointestinal tract(GIT). Impairment can be of single or multiple nutrients depending on the abnormality. This may lead to malnutrition and a variety of anaemias

3. CONT.. Malabsorption constitutes the pathological interference with the normal physiological sequence of body such as: Digestion Absorption Transport of nutrients.

4. PREVALENCE This condition is the United states is 1:133. Its prevalence in the united states is 20-100/100,000. More than 1 million causes/year

5. RISK FACTORS Medical conditions affecting the intestine Use of laxatives Excessive use of antibiotics Internal surgery Excessive use of alcohol Travel to counters with high incidences of intestinal parasites.

6. CAUSES Malabsorption occurs due to several causes :- gall-bladder and pancreatic disease lymphatic obstruction vascular impairment bowel resection PEM( protein energy malnutrition)

7. CONT.. Iron deficiency anemia Intestinal parasitosis Mild –to-moderate steatorrhea

8. INTESTINAL ABSORPTION PROCESS Absorption of the majority of nutrients takes place in the jejunum. Iron absorbed in the duodenum Vit B12 and bile salts are absorbed in the terminal ileum Water and lipids are absorbed by passive diffusion throughout the small intestine. Sodium is absorbed by active transport and glucose and amino acid co transport

9. PATHOPHYSIOLOGY

10. PRE MUCOSAL(LUMINAL ) Impaired digestion Bile acid / enzyme Deficiencies of fat

11. MUCOSAL Reduce absorption Bowel resection Disease affecting absorption

12. POST MUCOSAL (POST ABSORPTIVE) Alerted nutrient transport Vascular or lymphatic abnormalities

13. CLASSIFICATION

14. INVESTIGATIONS

15. Cont.. For fat malabsorption :- (It is the most common abnormality of malabsorption syndrome) 1.Glod standard 2.Sport test 3. Breath test

16. Cont.. For carbohydrate :- D- xylose test- It does not digest in GI tract but asborps in the GI tract. orally 25gm D- xylose given to the patient then if after 5 hrs urine D- xylose excreation is more than 4.5gm then the test is normal

17. Cont.. For vit.B12 malabsorption :- schilling test – This test worte same as D- xylose test. excreate is more than 1o% is abnormal less than 10% is normal

18. Cont.. BLOOD TEST:- Vit B12, iron , serum calicium , serum albumin , protein , phosphorus

19. Cont.. MRI (magnetic resonance imaging) ERCP (endoscopic retrograde cholangio pancreatography) ENOSCOPY ULTRASOUND

20. CLINICAL MENIFESTATION Chronic diarrhea Abdominal distension Failure to thrive (insufficient weight gain) Flatulence Anorexia Fatigue

21. Cont.. Loss of weight Direct consequence Malnutrition and growth failure Chronic diarrhea is presented as abnormal stools which continues or recurrently occurs over several months.

22. Cont.. Megaloblastic anemias Malnutrition Bone pain Milk intolerance Muscle cramping

23. Cont.. Stools may be loose and bulky in celiac disease, pasty and yellowish in exocrine pancreatic insufficiency. Non-specific chronic diarrhea in toddlers is presented as mucus containing, foul smelling stools.

24. DIARRHEA Diarrhea is the most common symptomatic complaint Diarrhea is defined as an increase in stool mass, frequency, or fluidity, typically greater than 200 g per day. In severe cases stool volume can exceed 14 L per day and, without fluid resuscitation, result in death. Painful, bloody, small-volume diarrhea is known as dysentery.

25. STEATORRHEA   It is the result of malabsorption of fat . The hallmark of steatorrhea is the passage of pale, bulky, and malodorous stools. Such stools often float on top of the toilet water and are difficult to flush. Also, patients find floating oil droplets in the toilet following defecation.

26. WEIGHT LOSS Weight loss is common and may be pronounced; however, patients may compensate by increasing their caloric consumption, masking weight loss from malabsorption .

27. ANEMIA Depending on the cause, anemia resulting from malabsorption can be either microcytic (iron deficiency) or macrocytic (vitamin B- 12 deficiency .

28. CONT… Ileal involvement in Crohn disease or ileal resection can cause megaloblastic anemia due to vitamin B- 12 deficiency . Iron deficiency anemia often is a manifestation of celiac disease .

29. BONE PAIN Malabsorption of calcium can lead to secondary hyperparathyroidism. Bone pain and pathologic fractures may be observed. Vitamin D deficiency can cause bone disorders, such as osteopenia or osteomalacia

30. COMPLICATION High temperature Weakness Cough Nausea Loss of appetite Weight loss

31. Cont.. Gall stone Anemia Kidney stone Osteoporosis Malnutrition Vitamin deficiencies

32. PREVENTION To spread infection, keep the toilet clean and wash the hands frequently with warm water and soap specially after the bowel movement. When travelling abroad or in areas with sanitation, drink only bottled water and eat only coked foods. Avoid contact with infected person if possible.

33. QUESTIONS What is defination of malabsorption syndrome? What are the main clinical manifestation ? What are the causes of malabsorption syndrome? What are the investigations of malabsorption syndrome?

34. TASK Write the nursing management of the malabsorption syndrome?