Symptoms and Diagnosis of Malabsorption

The initial stages of differential diagnosis of malabsorption syndrome are based on the evaluation of the character of the stool. Most diseases that occur with SMA are characterized by diarrhea or polyphecal. In certain diseases, the watery nature of the stool predominates (disaccharidase insufficiency, glucose-galactose malabsorption, chloride diarrhea, vipoma). Steatorrhea occurs in cystic fibrosis, abetalipoproteinemia, celiac disease, exudative enteropathy. Changes in the absorption of a number of trace elements, amino acids, vitamins do not affect the character of the stool, diarrhea does not occur, and the symptoms are associated with the formation of deficient conditions and can affect the function of many systems and organs (bone, lymphatic, nerve tissue, blood, eyes, etc.). ).

These differences in clinical symptoms in the syndrome of malabsorption significantly complicate the diagnostic program, forcing the use of modern methods of examination. In this case, one should not forget about anamnestic data, including a food history of the child, this information is important for choosing a diagnostic pathway and the appointment of adequate dietary and drug treatment.

For differential diagnosis it is important to take into account the age of the patient, the time of the onset of the first symptoms of the disease. In the period of the newborn, they manifest congenital deficiency of lactase, alaktasia, secondary lactase deficiency, congenital glucose-galactose malabsorption. Congenital chloride diarrhea, congenital sodium diarrhea, congenital deficiency of trypsinogen, primary hypomagnesemia, congenital deficiency of enterokinase, primary immune deficiency, enteropathic acrodermatitis. Intolerance to cow's milk protein and soy, Minkes disease. At the age of 1 month to 2 years, a deficiency of sugar, isomaltase, secondary disaccharidase deficiency, congenital lipase deficiency, pancreatic insufficiency with hematological changes (Schwamman-Diamond syndrome), celiac disease, intestinal lymphangiectasia, biliary atresia, neonatal hepatitis, malabsorption of amino acids, Congenital malabsorption of folic acid, malabsorption of vitamin B12, parasitic infections, food allergy, immune deficiency. At the age of 2 years before the pubertal period, symptoms of secondary disaccharidic insufficiency, celiac disease, Whipple's disease, parasitic infections, variable immune deficiency, and abelipoproteinemia develop.

Relationship of the manifestation of the disease with the characteristics of the baby's nutrition

Manifestation after administration	Diseases
Gluten-containing products	Celiac disease
Cow milk, milk formula	Intolerance to cow's milk proteins Lactase insufficiency
Sugar-containing products	Saccharose isomaltase deficiency
Different products	Food allergy and pseudoallergia
Breastfeeding	Inertial nutrition Enteropathic acrodermatitis

The connection between the deterioration of the chair and the child's eating habits

Foods provoking stool deterioration	Diseases
Dairy	Lactase insufficiency Intolerance of cow's milk proteins Glucose-galactose malabsorption
Products containing sucrose	Saccharose isomaltase deficiency Glucose-galactose malabsorption
Products containing glucose and galactose, but not fructose	Glucose-galactose malabsorption
Products containing starch	Malabsorption of starch (associated with exocrine pancreatic insufficiency or primary or secondary disturbance of parietal digestion)
Different products	Food allergy and pseudoallergia
Change in the amount of food administered	Inadequate nutrition GI tract anomalies Hormone-producing tumors
Fatty foods	Inadequate nutrition Diseases leading to exocrine pancreatic insufficiency Diseases of the liver and bile ducts

[1], [2], [3], [4], [5], [6], [7], [8]