Summary: Barry James, a 67-year-old man presents to the hospital with a recent onset of diarrhea and weight loss; patient has a history of lactose intolerance, vitamin B12 deficiency and intermittent diarrheal episodes that last 1-2 days. Peripheral edema was noted on the physical examination, and the abdominal examination was negative for distention and organomegaly.
Question: Describe the pathophysiology and clinical presentations associated with small intestine malabsorption.
Generate:
Malabsorption occurs when the small intestines are unable to appropriately absorb nutrients. Additionally, it can occur diffusely where several nutrients are not absorbed, or partially causing nutrient-specific malabsorption. Normally, three steps are involved in absorption: luminal processing, intestinal mucosal absorption and transport into circulation1; failure at any one of these steps can lead to malabsorption.
Fat Malabsorption
Hydrophobicity of phospholipids, triglycerides and cholesterol creates a challenge due to their …show more content…
Normally, fat-soluble vitamins (e.g., Vitamin A, D, K) are digested and absorbed similar to ingested fats.3 Essentially, fat-soluble vitamins are separated into micelles and absorbed across the intestinal epithelium prior to their entrance into the circulation. Resection of the terminal ileum can lead to bile salt deficiency as well as fat and fat-soluble vitamin malabsorption.3 Calcium absorption is largely dependent on Vitamin D. If the patient is Vitamin D deficient, then calcium absorption from the small intestine will be inadequate and calcium will be sequestered from the patient’s bones. This can lead to conditions such as osteopenia (reduced bone mass) or osteomalacia (softening of the bone).3 Since Mr. James did not have fat in his stool, it would make sense that his calcium levels were
Question: Describe the pathophysiology and clinical presentations associated with small intestine malabsorption.
Generate:
Malabsorption occurs when the small intestines are unable to appropriately absorb nutrients. Additionally, it can occur diffusely where several nutrients are not absorbed, or partially causing nutrient-specific malabsorption. Normally, three steps are involved in absorption: luminal processing, intestinal mucosal absorption and transport into circulation1; failure at any one of these steps can lead to malabsorption.
Fat Malabsorption
Hydrophobicity of phospholipids, triglycerides and cholesterol creates a challenge due to their …show more content…
Normally, fat-soluble vitamins (e.g., Vitamin A, D, K) are digested and absorbed similar to ingested fats.3 Essentially, fat-soluble vitamins are separated into micelles and absorbed across the intestinal epithelium prior to their entrance into the circulation. Resection of the terminal ileum can lead to bile salt deficiency as well as fat and fat-soluble vitamin malabsorption.3 Calcium absorption is largely dependent on Vitamin D. If the patient is Vitamin D deficient, then calcium absorption from the small intestine will be inadequate and calcium will be sequestered from the patient’s bones. This can lead to conditions such as osteopenia (reduced bone mass) or osteomalacia (softening of the bone).3 Since Mr. James did not have fat in his stool, it would make sense that his calcium levels were