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Alcohol-induced liver disease
Alpha 1-antitrypsin deficiency
Benign liver tumors
Cholestatic liver disease
Non-alcoholic fatty liver disease
Primary biliary cirrhosis
Primary sclerosing cholangitis
Pancreatic neuroendocrine neoplasms
Familial adenomatous polyposis
Juvenile polyposis syndrome
Small bowel ischemia and infarction
Protein losing enteropathy
Short bowel syndrome (NORD)
Small bowel bacterial overgrowth syndrome
Diverticulosis and diverticulitis
Irritable bowel syndrome
Cleft lip and palate
Congenital diaphragmatic hernia
Diffuse esophageal spasm
Eosinophilic esophagitis (NORD)
Gastroesophageal reflux disease (GERD)
Cyclic vomiting syndrome
Gastric dumping syndrome
Dental caries disease
Gingivitis and periodontitis
Temporomandibular joint dysfunction
Appendicitis: Pathology review
Cirrhosis: Pathology review
Colorectal polyps and cancer: Pathology review
Congenital gastrointestinal disorders: Pathology review
Diverticular disease: Pathology review
Esophageal disorders: Pathology review
Gallbladder disorders: Pathology review
Gastrointestinal bleeding: Pathology review
GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review
Inflammatory bowel disease: Pathology review
Jaundice: Pathology review
Malabsorption syndromes: Pathology review
Neuroendocrine tumors of the gastrointestinal system: Pathology review
Pancreatitis: Pathology review
Viral hepatitis: Pathology review
Malabsorption syndromes: Pathology review
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At the gastroenterology clinic, there is a 53 year- old man from the United Kingdom, named George, who came in complaining of periodic foul-smelling, bulky and frothy stools, as well as recurrent abdominal pain after meals and weight loss, despite not dieting.
On further history, he admits that he has been consuming alcohol with almost every meal for the last 10 years.
An upright abdominal x-ray shows calcifications in the epigastric area.
Next to him is a 9 year- old girl from Iran, named Yasmin, whose parents are concerned about her short stature and inadequate weight gain despite following a balanced diet.
On examination, her height and weight are below the 3rd percentile for her age and sex.
She also has an itchy rash consisting of small vesicles on both of her knees.
At first glance, you’d think George’s and Yasmin symptoms have nothing in common.
But the fact is, they both have different forms of malabsorption syndromes.
With malabsorption, nutrients are no longer effectively absorbed in the small intestine.
Malabsorption can either be global, meaning that the absorption of all nutrients is affected, or it can be partial, meaning that only specific nutrients cannot be absorbed.
In general, unabsorbed nutrients are allowed to linger in the gastrointestinal lumen for longer than usual, disrupting the proper formation of stool, which results in diarrhea, bloating and flatulence.
And since these nutrients are lost in the stool, malabsorption will also lead to unintentional weight loss and various nutritional deficiencies.
For macronutrients, let’s start big, with fat malabsorption which causes steatorrhea, meaning fatty, greasy, floating, voluminous and terribly smelling stools.
And it’s important to know that screening for fat malabsorption is done with a fecal fat test, known as Sudan III stain.
A high yield fact to remember is that there will also be a decrease in the absorption of the fat-soluble vitamins; A, D, E, and K, and that might be the only clue you get for fat malabsorption!
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