• Food is chemically reduced to digestive end products, made small enough to participate in the absorption process by various enzymes, and then transported across the intestinal epithelium by active transport, passive transport, facilitated diffusion, or endocytosis. Disruption of any of these physiologic stages may lead to maldigestion, malabsorption, or both. • Based on strong research evidence, the most common type of carbohydrate malabsorption is lactose malabsorption due to "adult-onset" lactase deficiency. (1) • Protein malabsorption leading to failure to thrive, hypoproteinemia, and edema occurs in pancreatic insufficiency, enterocyte deficiency, and impaired amino acid or peptide transport by the enterocyte. • Fat malabsorption occurs in pancreatic insufficiency, which can be congenital in conditions such as cystic fibrosis and Shwachman-Diamond syndrome, or acquired, as in chronic pancreatitis. Fat malabsorption also is seen in diseases that impair bile production or excretion and in abetalipoproteinemia. • A detailed history and physical examination and judicious use of laboratory studies usually provide the information necessary to diagnose a maldigestive or malabsorptive disorder. • Management aims at enabling patients to grow and develop normally.
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health