Term
Malabsorption Syndrome
Pathophysiology |
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Definition
| Malabsorption syndrome is associated with a variety of disorders and intestinal surgical procedures. It interferes with the ability to absorb nutrients and is a result of a generalized flattening of the mucosa of the small intestine. With various disorders, physiologic mechanisms limit absorption of nutrients because of one or more of these abnormalities: bile salt deficiencies, enzyme deficiencies, presence of bacteria, disruption of the mucosal lining of the small intestine, altered lymphatic and vascular circulation , and decrease in the gastric or intestinal surface area. |
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Term
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Definition
-Chronic Diarrhea
-Steatorrhea
-Edema |
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Term
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Definition
| Occurs as a result of unabsorbed nutrients, which add to the bulk of the stool, and unabsorbed fat. |
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Term
| Steatorrhea (greater than normal amounts of fat in the feces) |
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Definition
| Result of bile salt deconjugation, nonabsorbed fats, or bacteria in the intestine. |
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Term
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Definition
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Term
| Nutrition Managment Intervention |
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Definition
Low-fat diet for patients with galbladdder disease, cyctic fibrosis and severe steatorrhea
High-protein, high-calorie diet and small frequent meals are recommended for patients with a total gastrectomy.
Lactose-free diets for patient with lactase deficiency.
Gluten-free diets for those with celiac sprue.
Rationale- Nutrition managment is used to improve or resolve malabsorption. |
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Term
| Nutritional supplements Intervention |
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Definition
Supplements for specific deficiency:
Water-soluable vitamins (folic acid and vitamin B complexes)
Fat-soluable vitamins (vitamin A, vitamin D, vitamin K)
Minerals (Calcium, iron, magnesium)
Pancreatic enzymes (pancrelipase)
-Rationale: Nutritional supplements are necessary for proper absorption
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Term
| Drug Therapy Intervention |
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Definition
Antibiotics are used to treat tropical sprue, Whipple's disease, and other disorders involving bacterial growth
Antidiarrheal agents, anticholinergics, and IV fluids
Rationale: Antibiotics are used to treat the diseases that cause malabsorption.
Drug therapy is used to control the clinical manifestations of malabsorption. |
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Term
| Skin Protection Intervention |
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Definition
Use medicated wipes
Clean with mild soap and warm water after each stool
Provide a sitz bath several times per day
Apply a thin coat of vitamin A& D ointment after each stool
Keep patient off affected buttock area
Cover open areas with thin DuoDerm
Observe for fungal or yeast infections
Rationale: Special skin care is used because chronic diarrhea can cause problems to perineal area. These interventions decrease the risk of problems caused by chronic diarrhea. |
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Term
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Definition
A decrease in mean corpuscular volume (MCV), Mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) indicates hypochromic microcytic anemia resulting form iron deficiency.
Serum iron levels are low in protein malabsorption because of insufficient gastric acid for the use of iron.
Serum cholesterol levels are low from decreased absoprtions and digestion of fat.
Low calcium levels may indicate malabsorption of vitamin D and amino acids |
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Term
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Definition
Schilling test measures urinary excretion of vitamin B12 for diagnosis of pernicious anemia and other malabsorption syndromes
Biopsy of the small intestine is used for the diagnosis of tropical sprue or celiac sprue
Ultrasonography is used to diagnose pancreatic tumors and tumors in the small intestine that is causing the malabsorption |
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Term
| Trimethoprim/sulfamethoxazole |
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Definition
| Used to treat tropical sprue |
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Term
| Tetracycline and metronidazole |
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Definition
Used to treat bacterial overgrowth that can be caused by a variety of disorders
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Term
| Diphenoxylate hydrochloride |
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Definition
| Antidiarrheal used to decrease diarrhea |
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Term
| Dicyclomine hydrochloride |
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Definition
| Anticholinergic used to inhibit gastric otility |
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Term
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Definition
Chronic diarrhea-monitor frequency and characteristics of bowl movements
Steatorrhea-monitor for frequent loose stools, do an quantitative fecal fat analysis to determine steatorrhea
Edema-monitor for redness, swelling, and fluid retention
Skin breakdown-monitor redness, swelling, pain on perineal area |
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Term
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Definition
Laboratory values return to normal levels
Decreased diarrhea
No steatorrhea in stool
Decreased edema |
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