Diagnosis of mal-absorption Syndrome | Malabsorption Test | Malabsorption Diagnosis

Diagnosis of mal-absorption Syndrome | Malabsorption Test | Malabsorption Diagnosis . Diagnosis of mal-absorption SyndromeScreening tests for the diagnosis of mal-absorption syndrome

Hematological test

• Macrocytosis (increased size of cells) – suggests folate deficiency.
• Low serum B12 level is usually due to pernicious anemia.

Biochemical test

• Serum calcium is low in fat mal-absorption due to low vitamin D levels.
• Low serum albumin in advanced cases of mal-absorption.
• Low serum ferritin in absence of evidence of bleeding suggests mal-absorption.

Immunological test

• Elevated IgA-alpha-gliadin antibody levels are found in 80 to 90% of patients.

Stools test

• Microscopy for ova, cysts and other evidence of parasitic infection.
• Examination for fat- presence of fats suggests gut affection proximal to ileum and caecum sphincter.
  
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Further investigations

Small bowel biopsy

• Villous atrophy in celiac disease.
• Mucosal lesions in giardiasis.
• Enlarged macrophages in Whipple’s disease.

Radiology examination

• Barium meal X-ray may show delayed transit time or an abnormal intestinal pattern.
• X-ray of chest is done to rule out tuberculosis.
• Abdominal CT-scan is done to detect abdominal lymphadinopathy and gives assessment of pancreas. It helps detect tumors, calcification pseudo-cysts and atrophy in chronic pancreatitis.

Functional tests

• Tests for specific carbohydrate mal-absorption. ‘Breath hydrogen test’ is commonly used to diagnose lactose intolerance.
• Pancreatic function tests

Direct measurement of secretions.

NBT-PABA test (N-benzyl- tryosyl, para-amino benzoic acid test).

• Vitamin B12 absorption (Schilling’s) test.

Tests of small bowel contamination

• Aspiration of small bowel contents is sent for aerobic and anaerobic culture.
  
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• Glucose breathe test.