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Transcript
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
stomatitis,
•
Vitamin A, C, and niacin deficiencies seldom cause clinical problems.
•
Protein malabsorption may lead to hypoproteinemic edema, usually of the lower
limbs.
•
Dehydration, potassium loss, and muscle weakness can follow profuse diarrhoea.
•
Secondary endocrine deficiencies may result from malnutrition.
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