What is Malabsorption syndrome?Malabsorption syndrome is a disease resulting from impaired intestinal absorption of nutrients.What are the causes of Malabsorption syndrome?Malabsorption syndrome is usually caused by the following:A. Intraluminal defects1. Pancreatic enzymes or bile salt deficiencies2. Gastric or intestinal resection as a result of cancer or obstruction3. Bacterial overgrowth in the intestine resulting in less nutrient absorption4. Acid hypersecretion (Zollinger-Ellison) syndromeB. Intestinal Mucosal Defects1. Tropical or non tropical sprue characterized by abnormalities of the intestinal villi resulting in poor absorption of food2. Parasitic disease of the intestinal such as tape-worms which feeds through the mucosa of the intestine3. Tuberculosis of the intestine can cause damage to inner lining of intestine impeding absorption of food4. Chemotherapy, drug abuse, radiation can damage the mucosa of the intestinesC. Intestinal lymphatic abnormalities1. Lymphanigiectasia2. Congestive heart failure3. Constrictive pericarditisWhat are the symptoms of Malabsorption syndrome?A person who has Malabsorption syndrome has the following symptoms:1. Weight loss2. Anorexia or loss of appetite3. Abdominal distension and bloating4. Muscle wasting5. Steatorrhea (pale bulky frothy stools) usually frequentSigns:1. Vitamin deficiency especially vitamin B12 and K and folic acid2. Mineral deficiencies and anemiaHow is the Diagnosis of Malabsorption syndrome made?Diagnosis can usually be made by:1. History of weight loss2. Steatorrhea - measurement of fecal fat is low3. D-xylose test is abnormal indicating poor carbohydrate absorption4. Pancreatic function tests by duodenal aspiration5. Tests for bacterial overgrowth such as:a. bile acid breath testb. jejunal culturesc. urinary tryptophan metabolites6. Intestinal biopsyWhat is the treatment of Malabsorption syndrome?Treatment depends on the cause:Non-medicinal:1. Intravenous fluids, electrolytes, minerals, vitamins2. Intravenous nutrients and feeding3. Gluten free diet4. Restriction of dietary fat5. Medium chain triglycerides6. Lactose free dietMedicinal:1. Symptomatic treatment of abdominal pain (anticholinrgics) and diarrhea (Imodium)2. Pancreatic enzymes for pancreatic deficiency3. Folic acid, vitamins and minerals replacements4. Antibiotics and antiparasitics for intestinal infectionsWhat is the prognosis of Malabsorption syndrome?Prognosis depends on the underlying cause.Most patients usually recover if appropriately treatedRecurrence is quite common.What are the preventive measures for Malabsorption syndrome?Avoid Chemotherapy and drugs which affect the mucosa of the intestineAvoid food in the tropicsAvoid gastritis or excessive acid in the stomachTABLE OF CONTENTChapter 1 MalabsorptionChapter 2 Celiac DiseaseChapter 3 Crohn's DiseaseChapter 4 GiardiasisChapter 5 Pancreatic CancerChapter 6 , Tropical Sprue Dr. Kenneth Kee is a well-known medical doctor from Singapore who has been practicing medicine since 1972.He graduated from the University of Singapore and furthered his studies with a Master of Science in Health Management in 1991, followed by a Ph.D. in Healthcare Administration in 1993.Dr. Kee established Kee Clinic in 1974, located in the Holland Drive area of Singapore. The clinic has been a prominent feature of the community, offering general medical services for 5 decades.Dr Kee also served his country Singapore as a national service police Inspector at night from 1975 to 1985 while working at his clinic during the day.He had served as a police guard to the Woodland Petroleum Tanks at night during the Indonesian Confrontation period, took part in police rounds at night in the Beach Road area and taught First aid and emergency resuscitation to Police recruits.He received the Singapore Police Bicentennial 2020 Medallion on 1st March 2024 as recognition for his work in the Singapore Police.Even as he grew older, Dr. Kee continued to work actively in his clinic, although

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