How to Diagnose Malabsorption

Malabsorption is a condition that occurs when inflammation, disease, or injury prevents the small intestines from sufficiently absorbing nutrients. There are many different causes for malabsorption including cancer, celiac disease, and Crohn’s disease. By identifying the symptoms of malabsorption and getting proper treatment, you can help treat and prevent the condition from recurring.^{[1]XResearch source}

Part 1

Part 1 of 2:

Recognizing the Symptoms of Malabsorption

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1
Familiarize yourself with the risk factors for malabsorption. Any person can experience malabsorption, but certain factors can increase your risk of having problems with this condition. Being aware of your risk can help you recognize and treat it effectively.^{[2]XResearch source}
- If your body doesn’t produce certain digestive enzymes, you may be at risk for developing malabsorption.
- Congenital and/or structural defects and diseases of the intestinal tract, pancreas, gallbladder, and liver may increase your risk for malabsorption.
- Inflammation, infection and injury to your intestinal tract may increase your risk for malabsorption. Removal of portions of your intestine may also contribute to the condition.
- Radiation therapy can put you at risk for malabsorption.
- Certain conditions and diseases such as HIV, cancer, chronic liver disease, Crohn’s disease, and celiac disease can put you at greater risk for malabsorption.^{[3]XResearch source}
- The use of certain antibiotics, including tetracycline and cholestyramine, and drugs such as laxatives can increase your risk for malabsorption.
- If you have recently traveled to Southeast Asia, the Caribbean, India, or other countries that commonly face intestinal parasite problems, you may have been infected by a parasite that causes malabsorption.^{[4]XTrustworthy SourcePubMed CentralJournal archive from the U.S. National Institutes of HealthGo to source}
2
Identify potential symptoms. Malabsorption has many different symptoms that can range from mild to severe and are different depending on what nutrients your body has failed to absorb. Identifying potential symptoms that you have can help you get effective treatment as soon as possible.^{[5]XTrustworthy SourceJohns Hopkins MedicineOfficial resource database of the world-leading Johns Hopkins HospitalGo to source}
- Gastrointestinal issues such as chronic diarrhea, bloating, cramping, and flatulence are the most common symptoms. There may also be excessive fat in your stools, causing them to change in color and become more bulky.
- Changes in weight, especially weight loss, is a common symptom.
- Fatigue and weakness may accompany malabsorption.
- Anemia or excess bleeding are symptoms of malabsorption. Anemia can be a result of lack of vitamin B12, folate or iron. Insufficient vitamin K may cause excessive bleeding.
- Dermatitis and night blindness can indicate inadequate absorption of vitamin A.
- Cardiac arrhythmias, or irregular heart rhythms, may be present due to inadequate levels of potassium and other electrolytes.
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Observe your bodily functions. Watching your bodily functions closely if you suspect you have malabsorption. This can help you not only help you more easily identify symptoms, but may help you diagnose the condition and get proper treatment in a timely manner.^{[6]XResearch source}
- Pay attention to stools that are light in color, soft, bulky, and abnormally foul-smelling. These stools may also be difficult to flush or may stick to the sides of the toilet bowl.
- Notice if your belly swells or you have flatulence after eating certain foods.
- You may experience edema, a swelling of the legs, ankles, or feet caused by fluid retention.^{[7]XResearch source}
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Pay attention to structural weakness. Malabsorption can keep your body from thriving. This can occur in adults but is most common in children. Children who are at risk are often smaller and weigh less than children the same age and sex. Structural weaknesses such as brittle bones and weak muscles can occur from the condition. Paying attention to changes in your bones, muscles, or even hair can help you diagnose and get treatment for malabsorption.^{[8]XResearch source}
- The child's hair may become abnormally dry and they may lose more of it than normal.
- You may notice that the child is not growing or that their muscles are not developing. You may even notice that their muscles are getting weaker.^{[9]XResearch source}
- Pain in the child's bones or muscles, or even neuropathy (numbness in the extremities), can be a sign of certain types of malabsorption.

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Getting a Diagnosis and Treatment

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1
See your doctor. If you observe or experience any of the signs or symptoms of malabsorption in yourself or your child, and/or are at risk for the condition, see your doctor as soon as possible. Early diagnosis is critical to help treat the condition and prevent long-term damage, especially in children.^{[10]XResearch source}
- Your doctor may be able to diagnose malabsorption based on a detailed patient history.
- Your doctor may also use a variety of tests to help diagnose malabsorption.
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Describe your symptoms to your doctor. It’s important to recognize your specific symptoms and write them down before you see your doctor. Not only will this help you best explain the symptoms you’re experiencing and how you’re feeling, but will also ensure that you don’t forget potentially important information.
- Tell your doctor about the symptoms you experience and how they feel. For example, if you’re experiencing bloating and cramping, use descriptive words like severe, dull, or strong. You can use these kinds of terms to describe many physical symptoms.
- Mention how long you’ve had your symptoms. The more specific date you can pinpoint, the easier it may be for your doctor to figure out what is causing your symptoms.
- Note how frequently you have or notice symptoms. This information can also help your doctor figure out what’s causing your symptoms. For example, you could say “I have flatulence and bulky stools every day,” or “I have edema in my feet occasionally.”
- Let your doctor know about any changes in your life, such as increased stress.
- Provide your doctor a list of your medications, which may also exacerbate asthma.
If your doctor suspects that you have malabsorption, they may order tests after conducting your physical exam, asking a series of questions about your symptoms, and ruling out other causes. These tests can help confirm a diagnosis of malabsorption.^{[11]XResearch source}
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Provide a stool sample. It’s likely you will need to provide a stool sample for testing when your doctors suspects malabsorption. This can help confirm the diagnosis and help formulate an effective treatment plan.^{[12]XResearch source}
- The stool sample will be tested for excess fat since many malabsorption cases result in the poor absorption of fat. Your doctor may suggest ingesting excess fat over one to three days, and samples will be collected throughout this period of time.
- The sample may also be tested for bacteria and parasites.
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Have your blood or urine tested. Your doctor may order urine or blood tests if they suspect malabsorption. These tests analyze and can spot specific nutrient deficiencies, including anemia, low protein levels, vitamin deficiencies, and mineral deficiencies.^{[13]XResearch source}
- Your doctor will likely look at your plasma viscosity, vitamin B12 levels, red cell folate levels, iron status, clotting abilities, calcium levels, antibodies, and serum magnesium levels.
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Prepare to have imaging tests. Your doctor may want to examine the extent of damage caused by malabsorption. They may order that you get an X-ray, ultrasound or CT scan to see your intestines more closely.
- X-rays and CT scans make images of the inside of your abdomen it easier for your doctor to identify not only if you have malabsorption, but also exactly where the problem area(s) of the condition are. This can help them better formulate a treatment plan.
- Your doctor may order an X-ray, which will require you to sit still while a technician makes images of your small bowel. This can help better see damage in this lower section of your
- Your doctor may order a CT scan, which will require you to lie inside of a large scanner for a few minutes. A CT scan can show how severe the damage is to your intestines and help assess the type of treatment needed.^{[14]XResearch source}
- An abdominal ultrasound might be used to diagnose problems with the gallbladder, liver, pancreas, intestinal wall, or lymph nodes.^{[15]XResearch source}
- You might be asked to drink a barium solution that will allow technicians to view structural abnormalities more clearly.^{[16]XResearch source}
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Consider hydrogen breath tests. Your doctor may suggest using a diagnostic breath hydrogen test. This can detect lactose intolerance and similar sugar-based malabsorption conditions and can help your doctor formulate a treatment plan.^{[17]XResearch source}
- During the test, you will be asked to breathe into a special collection container.
- You will then be instructed to drink a lactose, glucose, or other sugar solution.
- Additional samples of your breath will be collected at 30-minute intervals and checked for bacterial overgrowth and hydrogen. Abnormal levels of hydrogen indicate an abnormality.
8
Collect cell samples from a biopsy. Less invasive tests could indicate a potential problem in your bowel lining due to malabsorption, and your doctor may order a biopsy the intestinal lining for further laboratory analysis.^{[18]XResearch source}
- The biopsy sample is usually taken during an endoscopy or colonoscopy.
9
Get treatment. Your doctor may prescribe a course of treatment for a diagnosed case of malabsorption based on the severity of your case.^{[19]XTrustworthy SourceJohns Hopkins MedicineOfficial resource database of the world-leading Johns Hopkins HospitalGo to source} There are different options that range from taking vitamins to hospitalization for severe cases.
- Be aware that even with early treatment, it may take a while to heal your body from malabsorption.
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Replace the nutrients previously lost. Once your doctor can diagnose which nutrients are not being absorbed by your body, they may prescribe taking vitamin and nutrient supplements and fluids to replace those lost.^{[20]XResearch source}
- Mild to moderate cases might be treated with oral supplements or a short dosage of nutrient-rich IV fluids.
- Your doctor may recommend a nutrient-dense diet for you to follow. The nutrients you're currently lacking will likely be increased in this diet plan.
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Work with your doctor to treat the underlying condition. Some causes of malabsorption are treatable by healing underlying causes. The exact treatment you need will vary based on the underlying condition causing your malabsorption, however, so work with your doctor to determine the best treatment for your particular circumstances.^{[21]XTrustworthy SourcePubMed CentralJournal archive from the U.S. National Institutes of HealthGo to source}
- Infections and parasites can usually be eliminated with medication, which may cure the malabsorption completely.
- Celiac disease requires you to remove gluten from your diet. Malabsorption from lactose intolerance may require avoiding dairy products.
- Pancreatic insufficiency may require the long-term usage of oral enzymes. Vitamin deficiencies may require the long-term use of vitamin supplements.
- Some causes, like blockages and blind loop syndrome, can require surgical intervention.

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Warnings

Schedule an appointment with your doctor as soon as you experience symptoms of malabsorption. You might be able to successfully diagnose malabsorption on your own, but you will not be able to determine the underlying cause and will therefore be unable to determine the best way to treat your condition.
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