From the Guidelines
Malabsorption causes diarrhea through several mechanisms related to the body's inability to properly absorb nutrients, water, and electrolytes in the intestines, leading to an osmotic gradient that pulls water into the intestine and results in loose, watery stools. When nutrients like fats, carbohydrates, or proteins are not absorbed properly, they remain in the intestinal lumen and create this osmotic gradient. Additionally, unabsorbed fats can directly irritate the colon, stimulating secretion and motility. Malabsorbed carbohydrates are fermented by colonic bacteria, producing gases and short-chain fatty acids that further draw water into the intestine and accelerate transit time. In conditions like celiac disease or inflammatory bowel disease, inflammation of the intestinal lining impairs absorption while simultaneously increasing intestinal secretions. Bile acid malabsorption, which can occur with ileal disease or resection, allows excess bile acids to reach the colon where they stimulate fluid secretion and increase motility, as seen in studies such as 1.
Mechanisms of Malabsorption
- Unabsorbed nutrients create an osmotic gradient, pulling water into the intestine
- Unabsorbed fats irritate the colon, stimulating secretion and motility
- Malabsorbed carbohydrates are fermented by colonic bacteria, producing gases and short-chain fatty acids
- Inflammation of the intestinal lining impairs absorption and increases intestinal secretions
- Bile acid malabsorption leads to excess bile acids in the colon, stimulating fluid secretion and motility
Treatment of Malabsorption
Treatment depends on addressing the underlying cause of malabsorption, which might include dietary modifications, enzyme supplements for pancreatic insufficiency, or specific medications for conditions like celiac disease or inflammatory bowel disease, as discussed in studies such as 1 and 1. It is essential to identify the specific cause of malabsorption to provide effective treatment and improve patient outcomes, as highlighted in guidelines such as 1.
Importance of Addressing Underlying Cause
Addressing the underlying cause of malabsorption is crucial to prevent complications such as dehydration, electrolyte imbalances, and malnutrition, which can significantly impact morbidity, mortality, and quality of life, as emphasized in studies such as 1. By understanding the mechanisms of malabsorption and providing targeted treatment, healthcare providers can improve patient outcomes and reduce the risk of long-term complications.
From the FDA Drug Label
Contact your healthcare provider if you continue to have signs and symptoms of malabsorption (not absorbing nutrients from food) such as abdominal pain, abdominal distention, bloating, fatty stools, or weight loss. Call your healthcare provider right away if you have any unusual or severe: ... nausea, vomiting, or diarrhea
Malabsorption can cause diarrhea as the body is not able to properly absorb nutrients from food, leading to abnormal bowel movements and gastrointestinal symptoms. If malabsorption occurs, it may lead to fatty stools, abdominal pain, bloating, and weight loss, in addition to diarrhea 2.
From the Research
Malabsorption and Diarrhea
Malabsorption can cause diarrhea due to various factors, including:
- Impaired nutrient absorption, leading to nutritional deficits and gastrointestinal symptoms 3
- Food intolerance and inappropriate diet, contributing to chronic diarrhea 3
- Villous atrophy of the small intestine, resulting in malabsorption of macro and micronutrients 4
- Carbohydrate malabsorption, such as lactose or fructose malabsorption, leading to diarrhea 5
Mechanisms of Malabsorption
Malabsorption can occur due to:
- Decreased intestinal absorption, commonly caused by celiac sprue 6
- Maldigestion caused by pancreatic insufficiency 6
- Congenital defects leading to malabsorption 5
- Immune-mediated enteropathy, such as celiac disease, resulting in villous atrophy and malabsorption 4
Consequences of Malabsorption
Malabsorption can lead to:
- Nutritional deficiencies and chronic diarrhea 3
- Persistent diarrhea despite treatment with a gluten-free diet 7
- Increased risk of intestinal lymphoma in patients unresponsive to a gluten-free diet 6
- Requirement for specialized nutritional support, such as enteral or parenteral administration, to treat severe caloric and micronutrient deficiencies 3