Malabsorption Syndrome

In malabsorption syndrome, the patient’s intestines no longer adequately absorb some or all of the nutrients from food into the bloodstream, resulting in nutrient deficiency. Malabsorption characterizes many congenital bowel disorders and intolerance to certain foods. In addition to dietary measures and treatment of the underlying disease, malabsorption syndrome usually involves substitution of nutrients by means of infusions.

Malabsorption Syndrome

What is Malabsorption Syndrome?

In the intestine, nutrients from food are absorbed, i.e. absorbed into the bloodstream. Absorption is a vital process that provides the body with irreplaceable substances. Impaired absorption of nutrients from the intestine can therefore have far-reaching consequences that can negatively affect the health of the body in many ways.

According to Dictionaryforall, absorption disorders in the area of ​​the intestine are summarized under the term malabsorption syndrome. The individual diseases form a large spectrum of different symptoms, all of which can be caused by disturbed substrate absorption from the intestine. The resulting deficiencies in the insufficiently absorbed substance manifest themselves in completely different clinical pictures.

The criterion for the inclusion of the individual diseases in the disease group malabsorption syndrome is solely the cause. In addition to intestinal diseases such as Crohn’s disease, all sensitivity disorders are among the best-known malabsorption syndromes. Maldigestion must be distinguished from malabsorption. In this phenomenon, the breakdown of the food components in the stomach is disturbed, which is usually caused by an enzyme defect or enzyme deficiency.


Malabsorption is caused by a chronic condition of the gut. In the case of malabsorption syndrome, the already broken down and thus pre-digested food cannot, or only insufficiently, release its nutrients through the intestinal wall into the lymphatic and blood vessels. This is the case, for example, with numerous congenital diseases, which are usually based on a mutation of certain intestinal components.

In addition, chronic inflammatory bowel diseases such as ulcerative colitis or Crohn’s disease can permanently damage the bowel, so that its elements can no longer easily fulfill the task of absorption. Hypersensitivity diseases such as celiac disease are also associated with malabsorption syndrome.

The same applies to infections such as Whipple’s disease. In certain cases, the syndrome can also develop from postoperative conditions, for example as a result of extensive removal of the small intestine. All diseases with the symptom of malabsorption are called malabsorption syndromes. A causal distinction is made with the subgroups congenital and acquired malabsorption syndromes.

Symptoms, Ailments & Signs

Patients with malabsorption syndrome mainly show mass stools with a stool weight of more than 300 grams as the main symptom. Foul-smelling fatty stools, which are also known as steatorrhea, often occur. In addition, the patients suffer from flatulence and thus excessive gas development, which can manifest itself in the form of flatulence or a painful bloated stomach.

Malabsorption often results in a greater or lesser loss of weight. Those affected develop certain deficiencies due to insufficiently absorbed nutrients. Typically, there is an undersupply of vitamins. Folic acid and minerals such as calcium and iron can also be associated with undersupply.

The same applies to protein and trace elements. Muscle weakness and skin and mucous membrane changes occur as a result of the insufficient supply. In most cases, patients also suffer from anemia, i.e. low blood count. All other symptoms depend on the causative disease in the individual case.

In obesity surgery, malabsorption is therapeutically induced to combat morbid obesity by manipulating the digestive tract in surgical procedures. In this case, too, lifelong deficiencies arise that must be medically monitored and treated.

Diagnosis & course of disease

The doctor develops the first suspicion of malabsorption syndrome during the anamnesis. For example, if the patient complains of facial thinning despite adequate calorie intake and no other medical conditions are present, malabsorption is an obvious conclusion. Finally, the doctor assesses the quality of the digestive processes by requesting a bowel movement from the patient.

The color, firmness, texture and quantity of the stool can confirm the suspected diagnosis and provide important information about the cause of the disease. The diagnosis can be further confirmed by means of sonography, various blood tests and an endoscopy. The prognosis depends on the type of malabsorption syndrome.


Due to the malabsorption syndrome, those affected suffer from reactively greasy and very heavy bowel movements. Flatulence and a bloated stomach also occur, so that the quality of life of the patient is significantly restricted by these symptoms. It is not uncommon for this syndrome to result in weight loss and a reduced supply of vitamins and other minerals.

The undersupply has a very negative effect on the health of the patient and can lead to various complaints and complications. Not infrequently, those affected also suffer from anemia and thus also from tiredness and exhaustion. Malabsorption syndrome can be treated relatively easily with the help of an appropriate diet.

Those affected are primarily dependent on low-fat meals. This means that most complaints can be limited relatively well. Complications do not arise in most cases. If there is an undersupply of trace elements, this undersupply must be compensated.

Various supplements are used. In many cases, those affected will depend on the supplements throughout their lives. However, with proper treatment, life expectancy is not limited or reduced.

When should you go to the doctor?

People who suffer from intolerance to different foods should have a medical examination carried out. If the number of foods increases, causing symptoms immediately after consumption, it is necessary to consult a doctor. If there is flatulence, digestive disorders or a fatty stool, a doctor should be consulted. Abdominal pain, a feeling of fullness and an increase in abdominal circumference should be checked out by a doctor. If the usual level of performance drops, if there is a reduction in muscle strength or if there are signs of a deficiency, a doctor is needed. An incomprehensible weight loss and pallor of the skin are further indications of an existing health impairment.

A doctor’s visit is advisable so that a diagnosis can be made and a treatment plan can be drawn up. Changes in the complexion and abnormalities in the mucous membranes in the mouth or throat must be presented to a doctor. Cold hands and feet are often signs of a circulatory disorder or an existing anemia. A doctor should be consulted if there is no improvement in the thermoregulation of the organism over a long period of time. If sleep disorders occur or if there are peculiarities in behavior, the person concerned needs help. A visit to the doctor is therefore recommended if you withdraw from social life or if you experience mood swings.

Treatment & Therapy

An important point in the treatment of malabsorption syndromes is diet. The patient must adapt their diet to the cause of the underlying disease. In the case of intolerances, for example, he abstains from the food intolerance from now on.

Since low-fat meat such as chicken, steamed fruit and four types of cooked vegetables are particularly easy to digest, these foods are often on the menu of those affected. Deficiency symptoms secondary to dietary measures must be ruled out as far as possible. Disorders of the water and electrolyte balance are usually counteracted in medicine by means of infusions.

The direct administration into the bloodstream bypasses the intestine and an existing deficiency of certain substances can be compensated. Vitamin deficiencies, mineral deficiencies and trace element deficiencies can also be counteracted with injections. In addition to this symptomatic treatment, the underlying disease is treated as far as possible.

If the intestines still retain their absorption capacity, a dietary supplement can already lead to compensating for nutrient deficiencies. Substitution by dietary supplements occurs, for example, in the case of obese patients in whom malabsorption was deliberately induced. Depending on the underlying disease, the substitution obligation can last a lifetime.

Outlook & Forecast

There is no uniform prognosis for malabsorption syndrome. It is a variety of partly congenital, partly acquired intestinal diseases. These are characterized by differently conditioned and differently serious uptake disturbances for certain nutrients.

As such, malabsorption syndromes pose a threat to general health. In some cases, the patient may receive the unabsorbed nutrients through IVs or pills. In some cases, a special diet or therapy tailored to the malabsorption can help. Above all, however, it must first be determined which form of malabsorption syndrome is actually present. Without this, a prognosis is not possible.

Depending on whether micro- or macronutrients are affected by the absorption disorder, the patient has a different quality of life. Malabsorption syndrome can affect only one nutrient, as in pernicious anemia. However, the organism can also get into a dangerous imbalance due to the insufficient absorption of all nutrients, as in the case of celiac disease.

The prognosis for malabsorption syndrome depends on how serious the disorder is, how early it is detected and what consequences it has for the organism. In many cases, the prognosis is quite good thanks to adequate treatment options. One of the exceptions, for example, is a congenital or surgically induced short bowel syndrome, where large parts of the small intestine are missing.


Malabsorption in the context of hereditary diseases cannot be actively prevented.


The aftercare of gastrointestinal diseases such as malabsorption syndrome depends primarily on the severity of the disease. This should be decided individually by the patient with his treating physician. Patients with malabsorption syndrome can suffer from various complications. However, these depend very much on the exact form of the syndrome, so that a general prediction about the further course cannot be made. Most patients suffer from greasy stools.

This leads to flatulence, constipation and also diarrhea. Many patients react to the state of emergency with depressive symptoms or other mental upsets. Part of the aftercare therefore focuses on restoring emotional stability and dealing with the situation safely. If weight loss occurs as a result of the malabsorption syndrome, which can be accompanied by deficiency symptoms, you should discuss with the doctor to what extent a substitution in the diet should be carried out. Every patient should also discuss with their family doctor whether a general change in diet is appropriate.

Many of those affected often suffer from inferiority complexes or a significantly reduced sense of self-esteem and do not dare to see a doctor with the symptoms. If the symptoms persist, the syndrome can damage the internal organs. This damage is often irreparable, so that the patient’s life expectancy can even be reduced.

You can do that yourself

Malabsorption syndrome is a collective term that encompasses many different gastrointestinal disorders. Therefore, the measures that the patient can carry out themselves depend on the respective cause. However, it should also be noted that many malabsorption disorders can only be treated by a doctor.

First, it is necessary to have the underlying condition diagnosed. Possible causes include celiac disease, fructose intolerance, lactose intolerance, liver and gallbladder diseases, chronic intestinal inflammation (Crohn’s disease), chronic pancreatitis or stomach diseases. With celiac disease, the patient must eat a gluten-free diet for life. The diet should also be adjusted if you have fructose intolerance. Since the personally tolerable dose of fructose varies here, the person concerned can test for himself how much fruit he can still tolerate after a diet low in fructose and fiber. However, sweet drinks and sugar should be avoided. In the case of lactose intolerance, the gastrointestinal disorders can be reduced by a low-lactose diet.nutrition.

However, if there is cirrhosis of the liver, the diet must also be low in protein. Patients with chronic pancreatitis are strongly advised to refrain from smoking and alcohol. Several small meals should be eaten that contain sufficient calories, vitamins and nutrients. In the case of stomach diseases, the patient can also try out what he tolerates. In any case, spicy food, alcohol or caffeine should be avoided.