Malabsorption is a state arising from an abnormality in the absorption of food nutrients across the gastrointestinal (GI) tract. Impairment can be of single or multiple nutrients depending on the abnormality. This may lead to malnutrition and a variety of anemias. If there is impairment of any of the many steps involved in the complex process of nutrient digestion and absorption, intestinal malabsorption may ensue. However, generalized malabsorption of multiple dietary nutrients develops when the disease process is extensive, thus disturbing several digestive and absorptive processes, as occurs in coeliac disease with extensive involvement of the small intestine. Siddha Spirituality of Swami Hardas Life System feels honored to bring such vital information for the well-being of all.
What is Malabsorption?
Malabsorption is a disorder that occurs when people are unable to absorb nutrients from their diets, such as carbohydrates, fats, minerals, proteins, or vitamins.
What are the basic categories of Malabsorption?
Some prefer to classify malabsorption clinically into three basic categories:
- Selective, as seen in lactose malabsorption.
- Partial, as observed in abetalipoproteinemia.
- Total, as in exceptional cases of coeliac disease.
What are the symptoms of Malabsorption
Depending on the nature of the disease process causing malabsorption and its extent, gastrointestinal symptoms may range from severe to subtle or may even be totally absent. Diarrhea, weight loss, flatulence, abdominal bloating, abdominal cramps, and pain may be present.
Although diarrhea is a common complaint, the character and frequency of stools may vary considerably ranging from over 10 watery stools per day to less than one voluminous putty-like stool, the latter causing some patients to complain of constipation.
On the other hand, stool mass is invariably increased in patients with steatorrhea and generalized malabsorption above the normal with 150–200 g/day. Not only do unabsorbed nutrients contribute to stool mass but mucosal fluid and electrolyte secretion is also increased in diseases associated with mucosal inflammation such as coeliac disease.
In addition, unabsorbed fatty acids, converted to hydroxy-fatty acids by colonic flora, as well as unabsorbed bile acids both impair absorption and induce secretion of water and electrolytes by the colon adding to stool mass.
Excessive flatus and abdominal bloating may reflect excessive gas production due to the fermentation of unabsorbed carbohydrates, especially among patients with primary or secondary disaccharidase deficiency. Malabsorption of dietary nutrients and excessive fluid secretion by inflamed small intestine also contribute to abdominal distention and bloating.
Prevalence, severity, and character of abdominal pain vary considerably among the various disease processes associated with intestinal malabsorption. For example, pain is common in patients with chronic pancreatitis or pancreatic cancer and Crohn’s disease, but it is absent in many patients with coeliac disease or postgastrectomy malabsorption.
Substantial numbers of patients with intestinal malabsorption present initially with symptoms or laboratory abnormalities that point to other organ systems in the absence of or overshadowing symptoms referable to the gastrointestinal tract. For example, there is increasing epidemiologic evidence that more patients with coeliac disease present with anemia and osteopenia in the absence of significant classic gastrointestinal symptoms. Microcytic, macrocytic, or dimorphic anemia may reflect impaired iron, folate, or vitamin B12 absorption.
Purpura, subconjunctival hemorrhage, or even frank bleeding may reflect hypoprothrombinemia secondary to vitamin K malabsorption. Osteopenia is common, especially in the presence of steatorrhea. Impaired calcium and vitamin D absorption and chelation of calcium by unabsorbed fatty acids resulting in fecal loss of calcium may all contribute.
Prolonged malnutrition may induce amenorrhea, infertility, and impotence. Edema and even ascites may reflect hypoproteinemia associated with protein-losing enteropathy caused by lymphatic obstruction or extensive mucosal inflammation.
Symptoms can manifest in a variety of ways and features might give a clue to the underlying condition. Symptoms can be intestinal or extra-intestinal – the former predominates in severe malabsorption.
- Diarrhea, often steatorrhoea, is the most common feature. Watery, diurnal, and nocturnal, bulky, frequent stools are the clinical hallmark of overt malabsorption.
- Growth retardation, failure to thrive, delayed puberty in children
- Swelling or edema from loss of protein
- Anaemias, commonly from vitamin B12, folic acid, and iron deficiency presenting as fatigue and weakness.
- Muscle cramp from decreased vitamin D, calcium absorption. Also, lead to osteomalacia and osteoporosis
- Bleeding tendencies from vitamin K and other coagulation factor deficiencies.
What causes Malabsorption
Malabsorption due to infective agents
- HIV related malabsorption
- Intestinal tuberculosis
- Parasites e.g. diphyllobothrium, giardiasis, hookworm
- Traveler’s diarrhea
- Tropical sprue
- Whipple’s disease
Malabsorption due to structural defects
- Blind loops
- Fistulae, diverticula, and strictures
- Infiltrative conditions such as amyloidosis, lymphoma, eosinophilic gastroenteritis
- Inflammatory bowel diseases, as in Crohn’s disease
- Radiation enteritis
- Short bowel syndrome
- Systemic sclerosis and collagen vascular diseases
Malabsorption due to surgical structural changes
- Bariatric surgery (Weight loss surgery)
- Gastrectomy; Vagotomy
Malabsorption due to mucosal abnormality
- Coeliac disease
- Cows’ milk intolerance
- Fructose malabsorption
- Soya milk intolerance
Malabsorption due to enzyme deficiencies
- Lactase deficiency inducing lactose intolerance
- Intestinal disaccharidase deficiency
- Intestinal enteropeptidase deficiency
- Sucrose intolerance
Malabsorption due to digestive failure
- Bile acid/Bile salt malabsorption
- Pancreatic insufficiencies:
- Carcinoma of pancreas
- Chronic pancreatitis
- Cystic fibrosis
- Zollinger-Ellison syndrome
Malabsorption due to other systemic diseases affecting the GI tract
- Addison’s disease
- Carcinoid syndrome
- Coeliac disease
- Common variable immunodeficiency (CVID)
- Fiber Deficiency
- Hypothyroidism and hyperthyroidism
- Diabetes mellitus
- Hyperparathyroidism and Hypoparathyroidism
The main purpose of the gastrointestinal tract is to digest and absorb nutrients (fat, carbohydrate, protein, micronutrients, vitamins, and trace minerals), water, and electrolytes. Digestion involves both mechanical and enzymatic breakdown of food. Mechanical processes include chewing, gastric churning, and the to-and-fro mixing in the small intestine. Enzymatic hydrolysis is initiated by intraluminal processes requiring gastric, pancreatic, and biliary secretions. The final products of digestion are absorbed through the intestinal epithelial cells.
Malabsorption constitutes the pathological interference with the normal physiological sequence of digestion, absorption, and transport (most mucosal events) of nutrients.
Intestinal malabsorption can be due to:
- Congenital or acquired reduction in absorptive surface
- Defects of ion transport
- Defects of specific hydrolysis
- Impaired enterohepatic circulation
- Mucosal damage (enteropathy)
- Pancreatic insufficiency
How to diagnose Malabsorption
There is no single, specific test for malabsorption. A range of different conditions can produce malabsorption and it is necessary to look for each of these. Many tests have been advocated, and some, such as tests for pancreatic function are complex, vary between centers, and have not been widely adopted. However, better tests have become available with greater ease of use, better sensitivity, and specificity for the causative conditions. Tests are also needed to detect the systemic effects of deficiency of the malabsorbed nutrients such as anemia with vitamin B12 malabsorption.
- Routine blood tests may reveal anemia, high CRP, or low albumin; which shows a high correlation for the presence of an organic disease. In this setting, microcytic anemia usually implies iron deficiency and macrocytosis can be caused by impaired folic acid or B12 absorption or both. Low cholesterol or triglyceride may give a clue toward fat malabsorption. Low calcium and phosphate may give a clue toward osteomalacia from low vitamin D.
- Specific vitamins like vitamin D or micronutrients like zinc levels can be checked. Fat-soluble vitamins i.e. A, D, E, and K are affected by fat malabsorption. Prolonged prothrombin time can be caused by vitamin K deficiency.
- Serological studies.
- Microscopy is particularly useful in diarrhea, may show protozoa like Giardia, ova, cyst, and other infective agents.
- Low fecal pancreatic elastase is indicative of pancreatic insufficiency. Chymotrypsin and pancreolauryl can be assessed as well
- Barium follow-through is useful in delineating small intestinal anatomy. A barium enema may be undertaken to see colonic or ileal lesions.
- CT abdomen is useful in ruling out structural abnormality, done in pancreatic protocol when visualizing the pancreas.
- Magnetic resonance cholangiopancreatography (MRCP) to complement or as an alternative to ERCP.
- OGD to detect duodenal pathology and obtain D2 biopsy (for coeliac disease, tropical sprue, Whipple’s disease, abetalipoproteinemia, etc.)
- Enteroscopy for enteropathy and jejunal aspirate and culture for bacterial overgrowth
- Capsule Endoscopy is able to visualize the whole small intestine and is occasionally useful.
- Colonoscopy is necessary for colonic and ileal disease.
- ERCP will show pancreatic and biliary structural abnormalities.
- 75SeHCAT test to diagnose bile acid malabsorption in ileal disease or primary bile acid diarrhea.
- Glucose hydrogen breath test for bacterial overgrowth
- Lactose hydrogen breath test for lactose intolerance
- Sugar probes or 51Cr-EDTA to determine intestinal permeability.
Obsolete tests no longer used clinically for Malabsorption
- D-xylose absorption test for mucosal disease or bacterial overgrowth. Normal in pancreatic insufficiency.
- Bile salt breath test to determine bile salt malabsorption.
- Schilling test to establish the cause of B12 deficiency.
How to manage Malabsorption
Treatment is directed largely towards the management of underlying cause:
- Replacement of nutrients, electrolytes, and fluid may be necessary. In severe deficiency, hospital admission may be required for nutritional support and detailed advice from dietitians. The use of enteral nutrition by nasogastric or other feeding tubes may be able to provide sufficient nutritional supplementation. Tube placement may also be done by percutaneous endoscopic gastrostomy or surgical jejunostomy. In patients whose intestinal absorptive surface is severely limited from disease or surgery, the long term total parenteral nutrition may be needed.
- Pancreatic enzymes are supplemented orally in pancreatic insufficiency.
- Dietary modification is important in some conditions:
- Gluten-free diet in coeliac disease.
- Lactose avoidance in lactose intolerance.
- Antibiotic therapy to treat Small Bowel Bacterial overgrowth.
- Cholestyramine or other bile acid sequestrants will help reducing diarrhea in bile acid malabsorption.
How to apply Siddha remedies for Malabsorption
1. Siddha preventive measures
Everybody must practice Siddha preventive measures, whether a person is affected with malabsorption or not, but preventive measures are the primary steps for switching on to any other Siddha remedies, and hence they are important. It helps in one’s capability, effectiveness, and productivity, decision making power, intellectuality, and removing minor health problems. There are three types of preventive measures:
- Earthing – performed for earthing the negativity of our body
- Field Cleaning – cleans the energy field (Aura) of our body
- Siddha Brain Exercise/Energizing – energizes our brain for proper functionality
Everybody’s tendency is to get attracted to the word ‘free‘, however, don’t neglect even these Siddha preventive measures are free. Avail of the benefits by practicing them sincerely, and regularly. For the ease of understanding what Siddha preventive measures are, please watch a video for a live demonstration.
2. Siddha Shaktidata Yog
This unique Siddha Shaktidata Yog of Siddha Spirituality can solve the problems related to malabsorption with Siddha remedies. There is no compulsion of training of ‘Swami Hardas Life System’ methods. This not only gives benefits to self but also it can be used for other affected persons, whether a person is in the same house, distantly available in the same city, same nation, or might be in any corner of the world, however, both the procedures have been explained here.
3. Siddha Kalyan Sadhana
Recite this Sadhana with a Sankalp “My problems of the malabsorption are solved as early as possible and I should gain health”, which should be repeated in mind 3 – 3 times every after each stanza. Any person irrespective of caste, creed, religion, faith, sex, and age can recite this Sadhana for free, which should be repeated at least twice a day. To know more, please click on this link.
4. CCPE products
These products work on the concepts of ‘Conceptual Creative Positive Energy’ (CCPE) within the provisions of the ‘CCPE Life System’ and the theory of Quantum Technology to a certain extent. However, the products get activated only whenever touched by a human and then they become capable of solving the problem and achieving health. However, please use these products for malabsorption as mentioned below:
CCPE Extractor: The CCPE Extractor should be gently moved over the Agya Chakra in a circular motion at least for 30 to 60 seconds, thereafter, follow the same process on the stomach and novel for another 30 to 60 seconds, which finishes within almost 2 – 4 minutes.
CCPE Booster: Keep one Booster over the Agya Chakra and another one each over the stomach and novel for 3 – 6 minutes. You may need to have 3 Boosters, which establishes positivity.
5. A daily routine for Malabsorption
In general, a daily routine may look like this:
- Increase physical activities e.g. exercise, walking, swimming, and consume Sattvik diet
- Perform breathing exercises regularly
- Apply free Siddha remedies a minimum 3 times a day, as explained above
- Practice Ananda meditation regularly
- In case, if someone wishes to learn advanced methods of Swami Hardas Life System, undergo unique training
- Perform Swayamsiddha Agnihotra daily, if feasible
Ensure to sprinkle in some fun during the day: Don’t forget to relax and laugh in between. Laughing is a great way to boost your immune system and help you.
Along with all the above activities, apply above explained free Siddha remedies minimum 3 times a day, the more is good. Just try the methods of Siddha Spirituality of Swami Hardas Life System. I am confident that you will surely find improvements within 7 days.
Training of Swami Hardas Life System
Any problem with regard to health, peace, and progress can be solved independently without money and medicines by undergoing training of Swami Hardas Life System. Any person irrespective of religion, caste, creed, faith, sex, and age can undergo this unique training.
In view of the above, I am confident that you have learned about malabsorption, symptoms, causes, diagnosis, basic categories, physiopathology, management, and Siddha remedies. Now, you have become self-sufficient, hence it’s the right time to use your acquired knowledge for solving problems as per the provision available in Siddha Spirituality of Swami Hardas Life System.
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