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Fat
Carbohydrate
(Lactose)
Vitamin
(B12, D)
Lactose Tolerance Test:
Feed adult 50 g lactose and measure rise in blood glucose.
An increase in BG < 20 mg/dL indicative of intolerance.
Hydrogen Breath Test
Feed 1.75 g lactose/kg BW; If present, undigested CHO
will be fermented by colonic bacteria and produce
large increase in Breath Hydrogen= Malabsorption
Organs participating: Liver (Bile) and Pancreas (Lipases)
Causes?
Bile Salt Insufficiency
Pancreatic Insufficiency
Compromised function of intestinal mucosa
(due to inflammation, infection, etc.)
Certain Drugs
Primary treatment: Fat-restricted diets
Enzyme replacement supplements
Water miscible vitamin supplements
Medium chain triglycerides (MCTs)
(8-12 carbon chain length don’t require
lipase and bile for absorption)
Refers to restriction of dietary triglycerides (TG)
not other types of lipids (e.g., cholesterol)
Commonly prescribed diets: 35 g or 50 g/ day
Highlights: Nonfat dairy products, cheeses
No added fat during food prep
< 3 eggs per week
< 6 oz lean meat or poultry/ day
3 servings of fat/ day
1 tsp butter/margarine
1 Tbs salad dressing
1 strip bacon
10 peanuts
Pluses
Minuses
Provide equal kcal
as LCT
No essential
fatty acids
Can mix with nL
liquids or use in
baking
Pt tolerates
only 20-60 g/ day
(< 500 kcal/ day)
too much?
N/v/d and distention
Disorders Associated with Malabsorption
Pancreatitis
Cystic Fibrosis
Acute and Chronic
The Inflamed Bowel
Blind Loop Syndrome
(bacterial overgrowth)
Crohn’s Disease
Ulcerative Colitis
Short Bowel Syndrome
Celiac Disease