Description
3-4 pages,
APA FORMAT
Discuss vitamin c, it's deficiency, sources, clinical features, differential Dr, and treatment options.
Include references

Explanation & Answer

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Malabsorption
Outline
• Normal digestion and absorption
• Classification of malabsorption
• Tests of malabsorption
• Clinical approach to diagnosis
• Management principles
Definition
• Malabsorptive syndromes are conditions that
cause insufficient assimilation of ingested
nutrients as a result either of maldigestion or
malabsorption.
Malabsorption vs. Maldigestion
Def: Decreased/impaired intestinal absorption
of macronutrients and/or micronutrients
• “malabsorption” – defect in mucosal
phase
• “maldigestion” – defect in intraluminal
phase
Normal Digestion and Absorption
• Mechanical mixing
• Enzyme and bile salt
production
• Mucosal function
• Blood supply
• Intestinal motility
• Commensal gut flora
Fat Digestion and Absorption
Carbohydrate and Protein Digestion and
Absorption
Protein Oligopeptides AA
Pancreatic proteases
Digestion
Mucosal peptidases
Absorption
Distribution
CHO Oligosaccharides Sugars
Pancreatic amylase
Mucosal disaccharidases
Absorption
• Three steps are required for normal nutrient
absorption:
• Luminal and brush border processing
• Absorption into the intestinal mucosa
• Transport into the circulation
Classification of Malabsorption
• Luminal
• Mucosal
• Postabsorptive
• Global/Total
• Partial
• Selective
• Overt
• Subclinical
• Asymptomatic
• CHO
• Protein
• Fat
Phase and nature of malabsorptive defect
Luminal phase
A. Substrate hydrolysis
1. Digestive enzyme deficiency - Chronic pancreatitis
2. Digestive enzyme inactivation - Zollinger-Ellison
syndrome
3. Dyssynchrony of enzyme release, inadequate mixing Post Billroth II procedure.
Phase and nature of malabsorptive defect
B. Fat solubilization
1. Diminished bile salt synthesis - Cirrhosis
2. Impaired bile secretion - Chronic cholestasis
3. Bile salt de-conjugation - Bacterial overgrowth
4. Increased bile salt loss - Ileal disease or resection.
Phase and nature of malabsorptive defect
C. Luminal availability of specific nutrients
1. Diminished gastric acid Atrophic gastritis vitamin B12
2. Diminished intrinsic factor Pernicious anemia
- vitamin B12
3. Bacterial consumption of nutrients
Phase and nature of malabsorptive defect
Mucosal phase
A. Brush border hydrolysis
1. Congenital disaccharidase defect Sucrase-isomaltase deficiency
2. Acquired disaccharidase defect Lactase deficiency
B. Epithelial transport
1. Nutrient-specific defects in transport Hartnup's disease
2. Global defects in transport Celiac sprue.
Phase and nature of malabsorptive defect
Postabsorpti...
