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Maldigestion / malabsorption

Maldigestion describes the inability of an individual to digest food in the gut [1] - malabsorption is the inability to absorb nutrients which have been digested from food through the gut.[1]

Causes of malabsorption can include:[2]

  • congenital heart disease
  • cystic fibrosis
  • gastroenteritis
  • HIV infection
  • liver disease
  • short-bowel syndrome
  • toddlers diarrhoea

Both maldigestion and malabsorption can lead to deficiencies, for example in vitamins and minerals as well as protein and energy. The complications that can develop depend upon which nutrients are affected. For example, a calcium and vitamin D deficit can lead to rickets and osteopenia.[3] Iron deficiency is associated with anaemia.[4] Zinc deficiency has been linked to poor growth.[5,6] Problems absorbing protein, fats and carbohydrates can culminate in weight loss and undernutrition with wasting and in severe cases stunting.

For children with malabsorption/maldigestion a semi-elemental feed is often recommended. These feeds contain pre-digested proteins (hydrolysed), a mix of medium and long-chain fats with simple sugars, which are easier to digest/absorb.

 

References

  1. World Gastroenterology Organisation (WGO) Practice Guideline: Malabsorption  (http://www.worldgastroenterology.org; cited 29 Feb 2012)
  2. Kleinman RE (ed). Pediatric Nutrition Handbook. Policy of the American Academy of Pediatrics. Elk Grove Village, 6th edition 2009.
  3. Brunner R, Doderlein L. Pathological fractures in patients with cerebral palsy. J Pediatr Orthop B 1996 Fall;5:232-8.
  4. Worldwide prevalence of anemia 1993-2005. WHO Global Database on anemia. Edited by Bruno de Benoist, Erin McLean, Ines Egli & Mary Cogswell. World Health Organisation, Geneva, 2008.
  5. Walravens PA. Nutritional importance of copper and zinc in neonates and infants. Clin Chem 1980;26:185-9.
  6. Prasad AS. Impact of the discovery of human zinc deficiency on health. J Am Coll Nutr 2009;28:257-65.
  7. Lambert B, Macdonald A, Booth IW. An open prospective randomised comparison of a newly available high energy enteral feed, with a conventional formula designed for children aged 16years. Proc Nutr Soc 1996;56:185A.