What Is Malabsorption?

hand with vegetables
Malabsorption can cause malnutrition, even with a balanced diet. Aaron Tilley/Getty Images

Malabsorption occurs when your digestive system fails to properly absorb the nutrients in your food so that your body can use them. Some types of malabsorption are much more serious than others.

When you have malabsorption related to certain conditions, such as celiac disease or inflammatory bowel disease, you can wind up with serious deficiencies in certain nutrients. It doesn't matter if you're eating a well-balanced, nutrient-filled diet that in theory should contain most of what your body needs to function properly — your condition prevents your body from absorbing those nutrients.

Other forms of malabsorption, such as those that may occur in non-celiac gluten sensitivity and in irritable bowel syndrome, are less onerous. They may result in unpleasant or even painful digestive symptoms such as bloating and gas, but they don't seem to cause nutrient deficiencies.

Here's a primer on malabsorption and its causes.

Malabsorption Frequent in Celiac Disease

People who have celiac disease have damage to their small intestines that can prevent them from absorbing multiple nutrients. In celiac disease, the gluten protein actually causes the body's immune system to mistakenly attack the small intestine. This attack damages or destroys the small intestinal lining, which is responsible for the work of nutrient absorption.

Iron deficiency frequently occurs as a result of celiac disease-induced malabsorption, and this can lead to anemia. In fact, the presence of otherwise unexplained anemia can provide a clue pointing to undiagnosed celiac, even when the person doesn't have obvious celiac disease symptoms.

Malabsorption due to intestinal damage in celiac disease also can lead to deficiencies in several important vitamins and minerals, which in turn can cause other health conditions.

Inflammatory Bowel Disorder Malabsorption

Malabsorption also can occur in inflammatory bowel disease, or IBD, and may lead to serious deficiencies in vitamins and minerals.

In IBD, which includes Crohn's disease and ulcerative colitis, intestinal inflammation can cause malabsorption of nutrients, and some of the medications used to treat IBD actually can inhibit the absorption of nutrients, making the problem worse.

In addition, advanced cases of IBD can lead to surgical treatment that removes part of the small intestine or colon. This treatment — while necessary — can add to problems the person might have absorbing nutrients from food. Physicians who treat IBD patients know to watch out for vitamin and mineral deficiencies that arise as a result of malabsorption.

Gluten Sensitivity Malabsorption May Involve Gluten Protein

In someone who has non-celiac gluten sensitivity, eating foods that contain gluten doesn't lead to nutritional deficiencies or to any intestinal damage. However, these foods can lead to gluten sensitivity symptoms that mimic celiac disease, including diarrhea, gas, bloating and brain fog.

It's not clear what may cause non-celiac gluten sensitivity (it's possible, in fact, that the culprit isn't gluten at all, but instead is another component of wheat and the other gluten grains, such as FODMAPs). However, some researchers believe the symptoms seen in the condition may be caused by malabsorption of gluten or of another compound found in gluten grains.

IBS Sufferers May Also Have Malabsorption

Physicians are recognizing that people with irritable bowel syndrome, or IBS, may also have certain types of malabsorption that contribute to their symptoms.

For example, people with IBS may not be able to properly absorb fructose, which is a type of sugar found in fruits, a few vegetables, and in many processed foods (in the form of high-fructose corn syrup). For these IBS sufferers, their fructose malabsorption doesn't cause vitamin deficiencies, but it can lead to unpleasant gas and bloating.

Many Other Types of Malabsorption

Malabsorption isn't limited to the above four conditions.

It's also possible to have lactose malabsorption (more commonly known as lactose intolerance), bile acid malabsorption (which may be the cause of diarrhea in certain people with IBS), steatorrhea (fat malabsorption found in cystic fibrosis and in some celiac disease cases), and malabsorption of nutrients due to excessive alcohol consumption.

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