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Malabsorption

Malabsorption involves problems with the body's ability to take in (absorb) nutrients from food.

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Causes

Many diseases can cause malabsorption. Most often, malabsorption involves problems absorbing certain sugars, fats, proteins, or vitamins. It can also involve an overall problem with absorbing food.

Problems or damage to the small intestine may lead to problems absorbing important nutrients. These include:

• Celiac disease
• Pancreatic exocrine insufficiency
• Tropical sprue
• Crohn disease
• Whipple disease
• Damage from radiation treatments
• Overgrowth of bacteria in the small bowel
• Parasite or tapeworm infection
• Surgery that removes all or part of the small intestine

Enzymes produced by the pancreas help absorb fats and other nutrients. A deficiency of these enzymes makes it harder to absorb fats and certain nutrients. Problems with the pancreas may be caused by:

• Cystic fibrosis
• Infections of the pancreas (pancreatitis)
• Trauma to the pancreas
• Surgery to remove part of the pancreas

Some of the other causes of malabsorption include:

• AIDS and HIV
• Certain medicines (tetracycline, some antacids, some medicines used to treat obesity, colchicine, acarbose, phenytoin, cholestyramine)
• Gastrectomy (removal of the stomach)
• Cholestasis
• Chronic liver disease
• Cow's milk protein intolerance
• Soy milk protein intolerance
• Surgical treatments for obesity

Symptoms

In children with malabsorption, the current weight or rate of weight gain is often much lower than that of other children of similar age and sex. This is called faltering weight. The child may not grow and develop normally.

Adults may also have failure to thrive, with weight loss, muscle wasting, weakness, and even problems thinking.

Changes in the stools are often present, but not always.

Changes in the stools may include:

• Bloating, cramping, and gas
• Bulky stools
• Chronic diarrhea
• Fatty stools (steatorrhea)

Exams and Tests

Your health care provider will take your medical history and do an exam. Tests that may be done include:

• Blood and urine tests
• CT scan of the abdomen
• Hydrogen breath test
• MR or CT enterography
• Serum methylmalonic acid (MMA) test for vitamin B12 deficiency
• Secretin stimulation test
• Small bowel biopsy
• Stool culture or culture of small intestine aspirate
• Stool fat testing
• X-rays of the small bowel or other imaging tests

Treatment

Treatment depends on the cause and is aimed at relieving symptoms and ensuring the body receives enough nutrients.

A high-calorie diet may be tried. It should supply:

• Key vitamins and minerals, such as iron, folic acid, and vitamin B12
• Enough carbohydrates, proteins, and fats

If needed, injections of some vitamins and minerals or special growth factors will be given. Those with damage to the pancreas may need to take pancreatic enzymes. Your provider will prescribe these if necessary.

Medicines to slow down the normal movement of the intestine can be tried. This may allow food to remain in the intestine longer.

If the body is not able to absorb enough nutrients, total parenteral nutrition (TPN) may be tried. It will help you or your child get nutrition from a special formula through a vein in the body. Your provider will select the right amount of calories and TPN solution. Sometimes, you can also eat and drink while getting nutrition from TPN.

Outlook (Prognosis)

The outlook depends on what is causing the malabsorption.

Possible Complications

Long-term malabsorption can result in:

• Anemia
• Gallstones
• Kidney stones
• Malnutrition
• Thin and weakened bones
• Weakened immune system

When to Contact a Medical Professional

Contact your provider if you have symptoms of malabsorption.

Prevention

Prevention depends on the condition causing malabsorption.

Related Information

References

Högenauer C, Hammer HF. Maldigestion and malabsorption. In: Chung RT, Rubin DT, Wilcox CM, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 12th ed. Philadelphia, PA: Elsevier; 2026:chap 106.

Semrad CE. Approach to the patient with diarrhea and malabsorption. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 126.

Review Date: 4/27/2026  

Reviewed By: Todd Eisner, MD, Private practice specializing in Gastroenterology in Boca Raton and Delray Beach, Florida at Gastroenterology Consultants of Boca Raton. Affiliate Assistant Professor, Florida Atlantic University School of Medicine. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 06/17/2026.

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