Disorders of intestinal secretion and absorption

Best Pract Res Clin Gastroenterol. 2009;23(3):395-406. doi: 10.1016/j.bpg.2009.04.005.

Abstract

The gastrointestinal tract possesses a huge epithelial surface area and performs many different tasks. Amongst them are the digestive and absorptive functions. Disorders of intestinal absorption and secretion comprise a variety of different diseases, e.g. coeliac disease, lactase deficiency or Whipple's disease. In principle, impaired small intestinal function can occur with or without morphological alterations of the intestinal mucosa. Therefore, in the work up of a malabsorptive syndrome an early small intestinal biopsy is encouraged in conjunction with breath tests and stool analysis to guide further management. In addition, there is an array of functional tests, the clinical availability of which becomes more and more limited. In any case, early diagnosis of the underlying pathophysiology is most important, in order to initiate proper therapy. In this chapter, diagnostic procedure of malabsorption is discussed with special attention to specific disease like coeliac disease, Whipple's disease, giardiasis and short bowel syndrome. Furthermore, bacterial overgrowth, carbohydrate malabsorption and specific nutrient malabsorption (e.g. for iron or vitamins) and protein-losing enteropathy are presented with obligatory and optional tests as used in the clinical setting.

Publication types

  • Review

MeSH terms

  • Breath Tests
  • Carbohydrate Metabolism / physiology
  • Celiac Disease / diagnosis
  • Celiac Disease / therapy
  • Fructose Intolerance / diagnosis
  • Fructose Intolerance / physiopathology
  • Gastrointestinal Diseases / diagnosis*
  • Gastrointestinal Diseases / physiopathology
  • Gastrointestinal Diseases / therapy
  • Giardiasis / diagnosis
  • Humans
  • Intestinal Absorption / physiology
  • Intestines / physiopathology*
  • Malabsorption Syndromes / diagnosis
  • Short Bowel Syndrome / diagnosis
  • Short Bowel Syndrome / microbiology
  • Short Bowel Syndrome / therapy