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Internal Medicine
b) Hypoparathyroidism
c) Drugs: neomycin, kanamycine may cause malabsorption.
Phenytoin causes a
selective folic acid malabsorption
Clinical features
Signs and symptoms
Symptoms of malabsorption are caused either by the effects of osmotically active
substances within the gastrointestinal tract or the resulting nutritional deficiencies.
Patients may present with some or all of the following clinical manifestations.
General symptoms:
Steatorrhea: passage of abnormal stools, which are greasy soft , bulky , and foul
smelling and may float in the toilet because of their increased gas content : a film of
greasy or oil droplets may be seen on the surface of the water . This is often
associated with abdominal distension, bloating, or discomfort and flatulence resulting
from increased intestinal bulk and gas production
Weight loss: which may be severe and involve marked muscle wasting.
Secondary nutritional deficiencies:
Deficiency of iron, folic acid, or B12 leading to anaemia
Calcium deficiency (common) partly due to lack of vitamin D causing rickets,
osteomalacia , paresthesia, tetany and carpopedal spasms.
Thiamine (vitamin B1) and B12 deficiency may cause neuropathy,
Malabsorption of vitamin K (mainly fat-soluble) can lead to hypoprothrombinemia
with bruising and a bleeding tendency.
Severe riboflavin (vitamin B2) deficiency may cause a sore tongue and angular
Vitamin A, C, and niacin deficiencies seldom cause clinical problems.
Protein malabsorption may lead to hypoproteinemic edema, usually of the lower
Dehydration, potassium loss, and muscle weakness can follow profuse diarrhoea.
Secondary endocrine deficiencies may result from malnutrition.