Digestion occurs in three phases. First, nutrients receive secretions from the pancreas and gall bladder, which begin the breakdown of food into its individual components. Next, the small intestine uses its brush border enzymes to further hydrolyze the food into absorbable molecules. Finally, the small intestine absorbs the nutrients into its walls for use in your body's nourishment. The waste that remains after absorption moves into the large intestine where it gets transported out of the body. If anything goes awry in any stage of this process, malabsorption results.
The digestive process begins as soon as food enters your mouth. The enzymes in your saliva and the process of chewing change the bite of food into a bolus -- chewed but undigested food matter. When you swallow, your throat thrusts the bolus into your esophagus, where the muscular contractions of its walls pass it to the stomach. When the bolus enters the stomach, acids and enzymes churn it into smaller bits of food. Only after the matter enters the small intestine and goes through the three stages of absorption does the bite of food you ingested break into individual molecules small enough to pass through the wall of your small intestine and provide nourishment to your body.
A number of conditions can cause a failure in the process of absorption. These include illness, medication, trauma and genetically-linked conditions. If you fail to absorb the nutrients in the food you eat, health issues arise. Some forms of malabsorption apply to most nutrients while others affect a particular one. The most common form of malabsorption, celiac disease, occurs in people who cannot digest gluten, a protein found in wheat, barley and rye grains. However, malabsorption can occur as a result of obstruction or disease of the gall bladder, liver failure, pancreatic disease, abnormal bowel mobility, overgrowth of bacteria and many other maladies and anomalies.
The number one symptom of the malabsorption of protein is edema. Without protein, you lose an important enzyme that aids in balancing your body's fluids. Your ankles, feet and hands get noticeably swollen. Your shoes and rings feel tighter and your joints feel stiff. If you press a finger into the lower part of your shin, you leave an imprint in the skin that takes many minutes to return to its normal shape. This demonstrates pitting edema. Malabsorption will cause you to lose weight, give you chronic diarrhea and abdominal distention. A child with celiac disease experiences a delay in growth. A variant of celiac symptoms can appear as a skin rash that has pustules and feels very itchy. Not all people with celiac disease experience a rash.
In the case of protein malabsorption, a gluten-free diet needs to be followed. You can probably get the protein you need from meat, poultry, fish, eggs and dairy. Carrying excess fluid around can place undue pressure on your heart and lungs. Diarrhea and weight loss will make you feel sluggish and weak. Books, diets and informational programs about a gluten-free diet abound. Many restaurants now offer dishes that contain no gluten. Within two weeks of switching to a gluten-free diet, your symptoms will improve. Be sure to visit your physician for a diagnosis before beginning the diet.
- The Merck Manuals Online Medical Library: Malabsorption Syndromes
- Health Communities: Absorption Disorders Overview
- "Current Medical Diagnosis and Treatment"; McPhee and Papadakis; 2010