You know you might have malabsorption from symptoms like chronic diarrhea, fatty/foul-smelling stools (steatorrhea), bloating, gas, and unintentional weight loss despite eating well, often due to poor absorption of nutrients leading to fatigue, anemia, or bone/muscle issues, requiring a doctor's diagnosis with blood, stool, breath tests, or intestinal biopsy.
Multiple stool studies can be performed to evaluate any patient with malabsorption particularly when it manifests as diarrhea. The patient is asked to ingest at least 80gm of fat per day, and stools are collected for 1–3 days. The total amount of fat excreted in the stool is determined in the laboratory.
Symptoms of different malabsorption syndromes can vary. They often include chronic diarrhea, abnormal stools, weight loss, and gas. Your doctor may use lab, imaging, or other tests to make a diagnosis.
Blood tests
These can be used to identify suspected malabsorption and are usually the first tests done. They are not specific because low levels of certain substances could be due to disorders other than malabsorption e.g. an unusual diet. Blood carotene levels are useful to screen for malabsorption.
The most common causes of malabsorption in developed countries are as follows:
People experiencing malabsorption will experience a variety of symptoms, like bulky stools, bloating, gas, cramping, chronic diarrhea and unexplained weight loss.
If you have gastroparesis, food stays in the stomach for longer than usual and may not be digested as easily. Symptoms of gastroparesis may include vomiting, heartburn, abdominal pain, diarrhoea, reduced appetite and weight loss.
Brown: Normal and healthy, comes from bile. Green: Often caused by leafy greens, iron supplements, or rapid transit through the intestines. Yellow or greasy: May suggest malabsorption, especially if stools are foul-smelling or float. Black: Can result from iron supplements, bismuth medications, or upper GI bleeding.
Carbohydrates, mainly sugars including lactose and fructose, or proteins (gluten), biogenic amines (e.g. histamine), may cause food intolerance/malabsorption complaints (3). These widely used food components are not digested well and/or absorbed properly during GI passage and then influence the microbiome.
Colonoscopy is the investigation of choice for diagnosis. Even a macroscopically normal mucosa on endoscopy can have abnormalities such as microscopic colitis and bile acid malabsorption (BAM).
Malabsorption of certain carbohydrates or proteins can occur as a side effect of gastrointestinal disease. (Fructose malabsorption is a common example.) But sometimes people are born lacking the necessary enzymes to break down certain nutrients. (Lactose intolerance is the most common example of this.)
How is malabsorption syndrome treated? Treatment for malabsorption syndrome may include a special diet, medicine to replace intestinal enzymes or reduce spasms, and vitamin or mineral supplements, such as B12 and iron.
Excess bile acids entering the colon can cause the classic signs and symptoms of bile acid malabsorption (BAM), including watery stool, urgency and fecal incontinence.
Tests for protein malabsorption are rarely used because fecal nitrogen is difficult to measure. Direct measurement of fecal fat from a 72-hour stool collection is the gold standard test for establishing steatorrhea but unnecessary with gross steatorrhea of obvious cause.
This malabsorption can result in nutritional deficiencies, which may trigger increased appetite and subsequent weight gain as the body tries to compensate for the lack of essential nutrients.
Steatorrhea is one of the clinical features of fat malabsorption and noted in many conditions such as exocrine pancreatic insufficiency (EPI), celiac disease, and tropical sprue. An increase in the fat content of stools results in the production of pale, large volume, malodorous, loose stools.
The hardest foods to digest are typically fried and fatty foods, processed foods, and some proteins like red meat, beans, and dairy (especially for lactose-intolerant individuals), along with high-fiber items like whole grains, cruciferous vegetables (broccoli, cabbage), and nuts/seeds, due to fat slowing digestion or fiber/complex carbs causing fermentation, gas, and bloating. Corn, spicy foods, onions, and caffeine can also be tough on the gut.
If you want to improve how your body breaks down food, and processes and absorbs your food's nutrients, try these malabsorption treatment natural ideas.
In The Article
Symptoms of the conditions associated with bleeding that cause iron deficiency anemia include: Dark, tar-colored stools or blood in the stool.
Change in the Appearance of the Stool
A Thin, narrow, or ribbon-like stool could indicate changes inside your colon. Color: Blood, darkened, or tarry (black) stool can signal issues inside the colon. Your doctor can help determine the cause.
Pale poop can appear white, gray, or clay-colored. It usually happens when your liver doesn't produce enough bile, often due to bile duct blockages, gallstones or liver problems. Call your healthcare provider if your poop is clay-colored for more than a few days.
Frequent discomfort, gas, bloating, constipation, diarrhea, and heartburn could be signs that your gut is having a hard time processing food and eliminating waste. You feel tired more often than not. People with chronic fatigue may have imbalances in the gut.
Signs and Symptoms of Stomach Cancer
Dumping syndrome is a condition in which food moves from the stomach into the small intestine too quickly after eating, more commonly seen after certain surgeries. It's sometimes called rapid gastric emptying. Dumping syndrome most often happens after surgery on the stomach or esophagus.