Medicine an Surgery notes

Apr 25th, 2015
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MALABSORPTION SYNDROMESEU, Department of PaediatricsDEFINITIONMalabsorption is a clinical term thatencompasses defects occurring during thedigestion and absorption of food nutrients bythe gastrointestinal tractImpairment can be of single or multiplenutrients depending on the abnormality.The major site of absorption is the smallintestineINTRODUCTIONCan be due to congenital abnormality in thedigestive or absorptive processes or, morecommonly, a secondarily acquired disorder ofsuch processes.INTRODUCTIONCarbohydrates Digestion starts in the mouth: starchessalivary amylase Pancreatic amylase reaches adult levels by 2ndsemester of life Cooked starch malabsorption is rare in infantsbecause of the activity of the brush-borderbound glucoamylase, an esoglycosidase thatdevelops early in life.INTRODUCTION Glucose and galactose : Active transport viacarrier protein known as SGLT-1 Fructose: facilitated diffusion (down aconcentration gradient)INTRODUCTION Proteins Proteins are first digested in the stomach, wherepepsinogens, which are activated to pepsins by a pH ofless than 4, hydrolyze them in large molecular weightpeptides duodenum pancreatic proteases (activatedby trypsin, secreted by the pancreas as a proenzyme,trypsinogen, which is subsequently activated by thebrush borderbound enterokinase) further split theminto low molecular weight peptides and free aminoacids. (70% LMW peptides and

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