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Malabsorption Syndrome: Symptoms, Causes & Treatment

Malabsorption Syndrome: Symptoms, Causes & Treatment

What is Malabsorption Syndrome?

Malabsorption syndrome is the low intestinal absorption of minerals, vitamins, carbohydrate, protein or fat. It’s associated with many symptoms, including persistent diarrhea, weight loss, gas, bloating and greasy stools (caused by high fat content).

Mineral and vitamin deficiencies caused by malabsorption syndrome may cause anemia, cheilosis (a dry scaling and fissuring of the angles of the mouth and lip surface) and glossitis (sore tongue).

Chronic diarrhea is usually the first symptom of malabsorption syndrome, prompting people to seek medical attention, but diarrhea doesn’t have to occur for a person to experience malabsorption. Fatty stools (steatorrhea) are also a sign of malabsorption syndrome. Feces may be foul smelling, frothy and may leave a circle of oil on the bathroom water.

The liver and gastrointestinal tracts play vital roles in nutrient digestion and absorption, as well as metabolism. Diseases of the liver and gastrointestinal tract may seriously upset normal nutrition.

Symptoms of Malabsorption Syndrome

The symptoms of malabsorption syndrome depend on the underlying cause, type of nutrient deficiency and how severe the deficiency is. Symptoms may appear quickly or develop gradually and get worse over time.

The body stores certain nutrients, including vitamin B12, and symptoms only occur when reserves are depleted. Symptoms caused by inadequate pancreatic enzymes might not occur until about 90 percent of the production capacity is upset in the body.

Some common symptoms seen with overall malabsorption include:

  • Chronic diarrhea
  • Failure to thrive (among children)
  • Abdominal pain, bloating, gas, and cramps
  • Greasy, loose and foul-smelling stools (steatorrhea)

Other symptoms may occur due to overall ill health or specific deficiencies caused by malabsorption syndrome. They can include (x):

  • Fatigue, weakness
  • Scaly and dry skin, rash
  • Ascites (fluid accumulation in the abdomen)
  • Glossitis (inflammation of tongue)
  • Unexplained weight loss, muscle wasting
  • Vomiting and nausea
  • Swelling of the legs, feet, and hands (peripheral edema)
  • Stomatitis (inflammation of mouth)
  • Paleness
  • Bone or muscle pain
  • Bleeding gums, easy bruising
  • Tingling and numbness in the hands and feet
Symptoms of Malabsorption Syndrome

Causes of Malabsorption Syndrome

Malabsorption syndrome is caused by various diseases. Most of the time, it involves difficulty absorbing certain vitamins, proteins, fats or sugars. It may also involve a general problem in absorbing food.

Damage to or problems with the small intestine may lead to difficulty absorbing vital nutrients. These problems can include (x):

  • Crohn’s disease
  • Celiac disease
  • Whipple disease
  • Topical sprue
  • Tapeworm or parasite infection
  • Damage caused by radiation treatments
  • Bacterial overgrowth within the small bowel
  • Surgery that removes part of or the entire small intestine

Enzymes made by the pancreas aid the absorption of fats as well as other nutrients. When these enzymes are running low, it becomes more difficult to absorb some nutrients and fats. Various triggers may cause problems to the pancreas, including surgery to the pancreas, damage to the pancreas, cystic fibrosis and swelling or infections of the pancreas.

Other possible causes of malabsorption syndrome are:

  • Cholestasis
  • Gastrectomy and obesity surgeries
  • Chronic liver disease
  • Intolerance to soy milk
  • Intolerance to cow’s milk protein
  • Certain medicines (some antacids, tetracycline, some obesity medicines, colchicine, phenytoin, cholestyramine, acarbose)

Treatment of Malabsorption Syndrome

Treatment options for malabsorption syndrome depend on the main cause. For example, a doctor will treat malabsorption due to lactose intolerance differently to malabsorption caused by liver disease. Most often, a low-fat, high-carbohydrate diet is ideal. It’s the easiest to digest as well as absorb.

In some cases, avoiding certain foods that worsen or trigger symptoms is the only treatment needed. For example, people with celiac disease can be treated by avoiding foods containing gluten, and those intolerant to lactose should steer clear of milk products.

Nutritional supplements can be prescribed. Common ones include vitamins K, E, D and A, iron, calcium and magnesium. Mineral and vitamin supplementation must be customized to individual needs, depending on clinical symptoms and serum levels.

To address the inadequate production of enzymes in the pancreas, pancreatic enzymes can be prescribed. Pancreatic enzymes come in tablets or capsules and, together with a low-fat diet, can benefit those with pancreatic disease.

To improve your digestion and absorption of nutrients, you can try the following natural ways to cope with malabsorption syndrome.

Chew Food Properly

Not chewing food properly can reduce the level of nutrients absorbed by your body from your diet (x).

Chewing properly allows your mouth to start the essential digestion process. Your food is broken down into smaller particles, so the fats and carbohydrates in your diet begin to be broken down by the saliva enzymes in your mouth. In addition, the saliva helps move your food smoothly through the intestines.

Eat More Fiber

Adults require not less than 30g of fiber daily from food only, yet most people get only around 15g of fiber a day (x).

Fiber provides numerous benefits, especially to people with malabsorption syndrome. By increasing your fiber consumption, you enhance digestion and shorten the time food lingers in your digestive system (x). As a result, your body gets ample time to process as well as absorb essential nutrients.

A fiber-rich diet helps reduces various digestive tract conditions, including irritable bowel syndrome and acid reflux (x).

Some excellent fiber sources include leafy green vegetables, legumes (kidney beans, black beans, pinto beans) and whole grains (quinoa, sprouted wholegrain bread, and steel-cut oatmeal).

Take Digestive Enzyme Supplements

Digestive enzymes are substances that help the body break down certain nutrients (x) and may help your body absorb more of the vital nutrients from foods.

For carbohydrate absorption, take enzymes like sucrase, lactase (perfect specifically for people with lactose intolerance), cellulase, amylase and maltase. For protein digestion, consider papain and bromelain. And for fat digestion, consider lipase.

Reduce Stress

Stress is invisible, but your digestive tract certainly can feel its impact. When you’re under severe pressure and experiencing anxiety or stress, proper digestion may not happen.

Harvard Medical School suggests that you try cognitive behavioral therapy, hypnosis or relaxation therapy in order to decrease stress and boost digestion (x). Other de-stressing techniques include deep breathing exercises, yoga and meditation.

Supplements for Malabsorption Syndrome

The supplements below can help promote your overall health, thereby helping relieve your malabsorption syndrome symptoms.


Zinc may benefit digestive, reproductive and immune health. It’s also added to toothpastes to maintain gum health.

Take 150 mg of zinc citrate powder up to three times a day. Don’t exceed 450 mg, no matter what.


Calcium carbonate is an excellent source of calcium. It consists of calcium, carbon and oxygen.

If you’re supplementing calcium carbonate for calcium deficiency or digestive discomfort, you should research this supplement to find out if it’s right for you.

Take around 1,250 mg of calcium carbonate once or twice daily, depending on your desired effect.

See Also
Irritable Bowel Syndrome

Vitamin D

Vitamin D aids calcium absorption and promotes the function of your immune system, muscles and nerves. Moreover, healthy vitamin D levels are linked to a reduced colon cancer risk, according to study done in 2015 (x).

Talk to your healthcare provider about the right daily dosage of vitamin D for you.

Omega-3 Fatty Acids

Omega-3s can help enhance the biodiversity of your gut, according to researchers at King’s College London and University of Nottingham (x). A digestive tract with rich, diverse bacteria is vital for your overall health.

Take three omega 3-6-9 softgels one to two times a day, or as suggested by your physician.

N-Acetyl Glucosamine

N-Acetyl D-Glucosamine (NAG) helps support the joints. It can also relieve indigestion.

Take 750 mg of N-acetyl glucosamine once or twice a day, or as instructed by your healthcare provider.


The anti-inflammatory properties of boswellia serrata extract are thought to ease joint pain. The extract also promotes gastrointestinal health.

Take 450 mg of boswellia one to two times a day, or as recommended by a doctor. This supplement is best taken with food.


Natural anti-inflammatory marshmallow root extract may relieve flu and cold symptoms, including cough and sore throat. It can also ease stomach pain.

The recommended dosage for marshmallow root extract is 1,200 mg, taken 1-2 times daily.


Curcumin is a natural antioxidant that contains anti-inflammatory effects that promote overall health.

Take 1,000mg of curcumin once daily, depending on your intended effect. You should take it with a meal or water.

The Bottom Line

Malabsorption syndrome occurs when your body is unable to digest and absorb food correctly, depriving your body of essential nutrients required for sustenance and growth. This disorder is often characterized by symptoms like unexplained weight loss and persistent diarrhea.

Many conditions can cause malabsorption syndrome. In most cases, malabsorption has to do with difficulty absorbing certain fats, sugars, vitamins or proteins. It may also have to do with an overall issue with absorbing food. Conditions that can make the small intestine unable to absorb vital nutrients include celiac disease, Crohn’s disease, tropical sprue, Whipple disease, excessive growth of bacteria in your small bowel and tapeworm or parasite infection.

Symptoms of malabsorption syndrome can be mild or severe and normally occur in the digestive tract, where absorption of nutrients is supposed to take place. These digestive tract symptoms include abdominal pain, bloating, gas and cramps, as well as chronic diarrhea. Other malabsorption symptoms include fatty, loose, foul-smelling stools (steatorrhea) and failure to thrive (among kids).

When the underlying cause of malabsorption syndrome is treatable, the main aim of treatment is to address the cause. At first, the doctor may recommend avoiding the type of food causing the problem, such as food containing lactose or gluten. The doctor may assess the nutrients contained in this food and recommend supplementation as a way of boosting nutritional intake.

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