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Internal Medicine
c) Collagenous sprue: deposition of collagen substance in the lamina propia of the
d) Non granulomatous ulcerative ileojejunitis a rare condition of unknown etiology
characterized by fever, weight loss and features of absorption.
e) Eosinophilic gastroenteritis: characterized by peripheral eosipnophilia, and
infiltration of the wall of the stomach, small intestine or colon by eosinophils. Many
patients present with specific food allergy.
f) Amylodosis : amyloid infiltration of the submucosa of the small intestine
g) Crohn’s diseases : an inflammatory bowel diseases which may cause mucosal
3) Inadequate absorptive surface: from extensive small bowel resection. Resection of 50
% of small intestine is well tolerated, if the remaining bowel is normal.
4) Lymphatic obstruction
a) Intestinal lymphangiectasia
b) Intestinal lymphoma
5) Multiple defects
a) After gastrectomy: which may result in poor mixing of gastric contents with
pancreatic enzymes and stasis in the afferent loops with bacterial overgrowth ( as in
Billroth II gastrectomy) can cause malabsorption.
b) Radiation enteritis: interferes with the blood supply of the intestine. Bacterial
overgrowth may occur secondary to radiation stricture , lymphatic obstruction may
occur due to edema or fibrosis
c) Diabetes mellitus: alter gut motility from diabetic neuropathy, bacterial overgrowth
and exocrine pancreatic insufficiency may lead to malabsorption.
6) Other causes
a) Infections : viral , bacterial or parasitic infections may cause malabsorption
i) In HIV infected patients malabsorption may be caused by Cryptosporidiosis ,
Isosporiosis or intestinal mucosal atrophy due to HIV virus itself (HIV
enteropathy )
ii) Tropical sprue: endemic malabsorption disorder occurring in the tropics. It is
believed to have an infectious cause.
iii) Parasitic cause of malabsorption: include Hookworm, tapeworm and