How Are You Diagnosed with Malabsorption?

Malabsorption Diagnosis: Tests, Signs & What to Expect

The human digestive system breaks down food and absorbs nutrients essential for the body’s growth, energy, and repair. When this process is disrupted, the body may fail to effectively absorb fats, proteins, carbohydrates, vitamins, or minerals.

This condition, known as malabsorption, can lead to a wide range of health problems, from fatigue and poor growth to severe nutritional deficiencies. Since malabsorption symptoms can be nonspecific and resemble many other conditions, identifying the root cause can be challenging without medical evaluation.

Therefore, timely and accurate diagnosis is crucial to managing symptoms, improving quality of life, and preventing long-term complications. Continue reading to find the diagnosis methods of malabsorption.

What are the methods to diagnose malabsorption?

Malabsorption diagnosis is a multi-step process involving clinical assessment, lab tests, and imaging or biopsy. Here’s how healthcare providers generally approach it:

1. Clinical History and Physical Examination

The first step in diagnosing malabsorption involves a detailed review of your symptoms, medical history, and dietary habits. Doctors will ask you about:

• Frequency and nature of bowel movements
• Unexplained weight loss
• Fatigue or weakness
• Recent travel (risk of infections)
• History of gastrointestinal diseases like coeliac or Crohn’s disease

A physical examination may reveal signs such as pale skin, a swollen abdomen, muscle wasting, or skin rashes associated with nutrient deficiencies.

2. Stool Tests

These tests help detect undigested stool nutrients, fat, or infections. They include:

• Faecal Fat Test: The 72-hour fecal fat test measures fat excretion in stool while the patient consumes a high-fat diet. Elevated levels confirm fat malabsorption.
• Stool Elastase: Detects pancreatic insufficiency. Low levels suggest the pancreas is not producing sufficient digestive enzymes.
• Occult Blood Test: Checks for hidden blood, which may indicate inflammation or infection.
• Parasite Tests: Rule out infections like Giardia or tapeworms, which can interfere with nutrient absorption.

3. Blood Tests

Blood tests help detect nutritional deficiencies and underlying conditions. Here are some of them:

• Complete Blood Count (CBC):Low haemoglobin or abnormal red cells may indicate iron or vitamin B12 deficiency.
• Electrolyte and Protein Levels:May show dehydration or protein-losing conditions.
• Vitamin and Mineral Levels:These include vitamin D, B12, calcium, magnesium, folate, and iron.
• Coeliac Screening:Blood tests like anti-tTG (anti-tissue transglutaminase) or anti-endomysial antibodies help detect coeliac disease.

4. Breath Tests

These are non-invasive and used to detect issues such as carbohydrate malabsorption or bacterial overgrowth. They include:

• Hydrogen Breath Test: This test measures hydrogen gas after ingesting lactose or glucose. High levels may suggest lactose intolerance or small intestinal bacterial overgrowth (SIBO).
• Methane Breath Test: This test is used alongside hydrogen testing for a more complete picture.

5. Endoscopy and Biopsy

If the initial tests are inconclusive or suggest a chronic intestinal illness, other tests may be prescribed, such as:

• Upper Endoscopy: A flexible tube is inserted through the mouth to examine the stomach and small intestine.
• Duodenal Biopsy: A small sample is taken from the small intestine to check for damage, particularly in suspected coeliac disease or tropical sprue.
• Colonoscopy: May be performed if inflammatory bowel disease (IBD) or microscopic colitis is suspected.

6. Imaging Tests

Specific imaging methods help assess structural or functional abnormalities:

• CT (computed tomography) scan or MRI (magnetic resonance imaging):These are useful in detecting tumours, inflammation, or bowel obstruction.
• Abdominal Ultrasound: Helps visualise organs like the pancreas or liver.
• Barium Studies: Barium is swallowed or introduced into the rectum to outline the gastrointestinal tract on X-rays. However, barium studies were historically used to visualize the GI tract but are now largely replaced by CT, MRI, or endoscopic methods.

What are the treatment options for malabsorption?

Treatment for malabsorption depends entirely on the underlying condition. The goal is to manage symptoms, correct nutritional deficiencies, and treat the underlying issue. The standard treatment options include:

• Nutritional Support: This encompasses vitamin and mineral supplements (iron, B12, and D), high-calorie and protein diets, and rehydration for chronic diarrhoea.
• Medication: Enzyme therapy for pancreatic issues, antibiotics for bacterial overgrowth, a gluten-free diet for coeliac disease, anti-inflammatory drugs for autoimmune disorders, and antiparasitics for infections.
• Root Cause Treatment: Manage chronic diseases, avoid trigger foods, and consider surgery for structural issues.

What Happens If Malabsorption Goes Untreated?

Ignoring or delaying the treatment of malabsorption can lead to serious medical consequences such as:

• Nutritional Deficiencies: Deficiencies in iron, calcium, folate, vitamin B12, and fat-soluble vitamins (A, D, E, K) may lead to fatigue, bone loss, nerve damage, and poor immunity.
• Growth and Development Issues: Untreated malabsorption can cause growth delays, weight loss, irritability, and developmental delays in children.
• Chronic Disease: Prolonged malabsorption may worsen underlying diseases or lead to new ones such as osteoporosis, infertility, or organ dysfunction.
• Dehydration and Electrolyte Disturbance: Severe diarrhoea can result in dangerously low potassium, sodium, or magnesium levels, which can affect the heart and muscles.
• Reduced Quality of Life: Ongoing symptoms may affect daily activities, social life, and mental well-being.

How Can You Prevent Malabsorption?

While not all causes of malabsorption are preventable, certain lifestyle and medical choices can significantly reduce the risk, such as:

• Maintaining a Healthy Diet: Ensure regular intake of all essential nutrients, especially if following restricted diets (e.g., vegan or gluten-free).
• Managing Chronic Diseases: Manage conditions such as diabetes, thyroid disease, and inflammatory bowel disease through routine check-ups.
• Staying Up to Date on Vaccinations: Vaccines like rotavirus and hepatitis can reduce gastrointestinal infections, which may impair absorption.
• Avoiding Self-Medication: Overuse of antibiotics, laxatives, or antacids can disrupt gut health and worsen absorption.
• Being Cautious When Travelling: Practise food and water safety measures in areas with high risk for intestinal infections.
• Monitoring Digestive Symptoms: Avoid persistent bloating, diarrhoea, or unexplained weight loss. Early intervention can prevent escalation.

Malabsorption is a complex but manageable condition if diagnosed early through the right combination of medical history, lab tests, and imaging. Its wide range of symptoms can affect various body systems, making it essential not to ignore signs like persistent diarrhoea, weight loss, or fatigue.

If you suspect you or a loved one may be experiencing symptoms of malabsorption, do not delay seeking medical advice. It is also advised to have health insurance to secure your health and finances during critical times.

At Star Health, we offer comprehensive coverage for various diseases and their treatment under our insurance plans. We also provide hassle-free claim settlements with reduced turnaround time at over 14,000 network hospitals in India.