Other Malabsorption Syndromes

Other Malabsorption Syndromes

·        Lactose Intolerance:

o  Lactose intolerance very common: especially where diary products are uncommon. Either congenital (rare), acquired, or secondary to enteritis (i.e. be careful with milk for several weeks after bad diarrhoea)

o  Lactose breath test: Give lactose. Broken down by lactase. If ¯lactase then osmotic diarrhoea ® rapid transit ® early & large rise in H₂ as lactose is broken down by bacteria. Check with serial breath H₂ measurements

·        Tropical Sprue:  Enterotoxic E coli infection in visitors to the tropics.  Affects distal intestine

·        Whipple's Disease: Tropheryma whippelii (bacteria) infection. Obstruction to lymphatics causes malabsorption. Treat with erythromycin, otherwise death from systemic spread

·        Abetalipoproteinaemia: genetic defect, unable to synthesise apoproteins