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Review
. 2014 Jun;30(3):150-4.
doi: 10.1159/000364794.

The Pathophysiology of Malabsorption

Jutta Keller  1 , Peter Layer  1
Affiliations
Review

The Pathophysiology of Malabsorption

Jutta Keller et al. Viszeralmedizin. 2014 Jun.

Abstract
in English, German

Physiological digestion and absorption of nutrients within the gastrointestinal tract requires a complex interaction between motor, secretory, digestive, and absorptive functions that is vulnerable to a multitude of potential disturbances which may lead to global or specific malabsorption syndromes. Potential pathomechanisms that are illustrated in this article include insufficient mechanical breakdown of harder food components due to chewing problems and/or decreased antral contractility, critical reduction of time for absorption in patients with markedly enhanced upper gastrointestinal transit (e.g. dumping syndrome), impaired digestion and absorption of nutrient components caused by reduced gastric acid secretion, pancreatic exocrine insufficiency or reduced biliary secretion, defects of the enteral mucosa with enzyme deficiencies (e.g. disaccharidases) or lack of specific carrier mechanisms (e.g. hexose or aminoacid transporters), and critical quantitative loss of intestinal mucosa in patients with short bowel syndrome.

Die physiologische Digestion und Absorption von Nährstoffen im Magen-Darm-Trakt erfordert ein komplexes Zusammenspiel motorischer, sekretorischer, digestiver und absorptiver Funktionen, das anfällig ist für eine Vielzahl möglicher Störungen, die zu globalen oder spezifischen Malabsorptionssyndromen führen können. Die in diesem Artikel beleuchteten potenziellen Pathomechanismen schließen die folgenden Störungen ein: unzureichende mechanische Zerkleinerung harter Nahrungsbestandteile bei Kauproblemen oder antraler Hypokontraktilität, kritische Verkürzung der zur Resorption zur Verfügung stehenden Zeit bei starker Beschleunigung des Transits im oberen Gastrointestinaltrakt (z.B. Dumping-Syndrom), Maldigestion und Malabsorption bei unzureichender gastraler Säuresekretion, exokriner Pankreasinsuffizienz oder gestörter Gallesekretion, Enzymmangel der Enterozyten (z.B. Disaccharidasemangel) oder defekte Transportermechanismen (z.B. Hexose-oder Aminosäuretransporter) sowie kritischer quantitativer Verlust von intestinaler Mukosa bei Kurzdarmsyndrom.

Keywords: Gastric acid secretion; Malabsorption; Maldigestion; Motility disturbances; Pancreatic exocrine insufficiency.

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References

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