Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Practice Guideline
. 2025 May;13(4):599-613.
doi: 10.1002/ueg2.70012. Epub 2025 Mar 25.

European Consensus on Malabsorption-UEG & SIGE, LGA, SPG, SRGH, CGS, ESPCG, EAGEN, ESPEN, and ESPGHAN. Part 1: Definitions, Clinical Phenotypes, and Diagnostic Testing for Malabsorption

Marco Vincenzo Lenti  1   2 , Heinz Florian Hammer  3 , Ilja Tacheci  4 , Rosa Burgos  5 , Stephane Schneider  6 , Anastasiou Foteini  7 , Aleksejs Derovs  8 , Jutta Keller  9 , Ilse Broekaert  10 , Marianna Arvanitakis  11 , Dan Lucian Dumitrascu  12   13 , Oscar Segarra-Cantón  14 , Željko Krznarić  15 , Juris Pokrotnieks  8   16 , Gonçalo Nunes  17   18 , Johann Hammer  19 , Loris Pironi  20   21 , Marc Sonyi  22 , Cristina Maria Sabo  12   13 , Juan Mendive  23 , Adrien Nicolau  6 , Jernej Dolinsek  24   25 , Denisa Kyselova  26 , Lucrezia Laterza  27   28 , Antonio Gasbarrini  27   28 , Teodora Surdea-Blaga  12   13 , Jorge Fonseca  17   18 , Christos Lionis  29 , Gino Roberto Corazza  1   2 , Antonio Di Sabatino  1   2
Affiliations
Practice Guideline

European Consensus on Malabsorption-UEG & SIGE, LGA, SPG, SRGH, CGS, ESPCG, EAGEN, ESPEN, and ESPGHAN. Part 1: Definitions, Clinical Phenotypes, and Diagnostic Testing for Malabsorption

Marco Vincenzo Lenti et al. United European Gastroenterol J. 2025 May.

Abstract

Malabsorption is a complex and multifaceted condition characterised by the defective passage of nutrients into the blood and lymphatic streams. Several congenital or acquired disorders may cause either selective or global malabsorption in both children and adults, such as cystic fibrosis, exocrine pancreatic insufficiency (EPI), coeliac disease (CD) and other enteropathies, lactase deficiency, small intestinal bacterial overgrowth (SIBO), autoimmune atrophic gastritis, Crohn's disease, and gastric or small bowel resections. Early recognition of malabsorption is key for tailoring a proper diagnostic work-up for identifying the cause of malabsorption. A patient's medical and pharmacological history is essential for identifying risk factors. Several examinations such as endoscopy with small intestinal biopsies, non-invasive functional tests and radiological imaging are useful in diagnosing malabsorption. Because of its high prevalence, CD should always be looked for in cases of malabsorption with no other obvious explanations and in high-risk individuals. Nutritional support is key in the management of patients with malabsorption; different options are available, including oral supplements, enteral or parenteral nutrition. In patients with short bowel syndrome, teduglutide proved effective in reducing the need for parenteral nutrition, thus improving the quality of life of these patients. Primary care physicians play a central role in the early detection of malabsorption and should be involved in multidisciplinary teams for improving the overall management of these patients. In this European consensus, involving ten scientific societies and several experts, we have dissected all the issues around malabsorption, including the definitions and diagnostic testing (Part 1), high-risk categories and special populations, nutritional assessment and management, and primary care perspective (Part 2).

Keywords: breath test; coeliac disease; diarrhoea; enteropathy; nutrition; pancreatitis; weight loss.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

References

    1. Losowsky M. S., Walker B. E., and Kelleher F., Malabsorption in Clinical Practice (Churchill Livingstone, 1974).
    1. Gasbarrini G., Corazza G. R., Vaira D., et al., Critical Evaluation of Malabsorption Tests (In Dobrilla G. Problems and Controversies in Gastroenterology) (Raven Press, 1986): Cortina International – Verona.
    1. Page M. J., McKenzie J. E., Bossuyt P. M., et al., “The PRISMA 2020 Statement: An Updated Guideline for Reporting Systematic Reviews,” BMJ 372 (2021): 71, 10.1136/bmj.n71. - DOI - PMC - PubMed
    1. Di Sabatino A., Lenti M. V., and Corazza G. R., “Malabsorption and Malabsorption Tests: Do They Still Matter?,” Digestive and Liver Disease 46, no. 5 (2014): 389–390, 10.1016/j.dld.2014.01.163. - DOI - PubMed
    1. Boltin D., Lambregts D. M., Jones F., et al., “Quality of Care Taskforce, UEG. UEG Framework for the Development of High‐Quality Clinical Guidelines,” United European Gastroenterology Journal 8, no. 8 (2020): 851–864, 10.1177/2050640620950854. - DOI - PMC - PubMed

Publication types