Malabsorption Syndrome: Treatment
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Fluid and nutrient monitoring and replacement is essential for any individual with malabsorption syndrome. Hospitalization may be required when severe fluid and electrolyte imbalances occur. Consultation with a dietitian to assist with nutritional support and meal planning is helpful. If the patient is able to eat, the diet and supplements should provide bulk and be rich in carbohydrates, proteins, fats, minerals, and vitamins. The patient should be encouraged to eat several small, frequent meals throughout the day, avoiding fluids and foods that promote diarrhea. Intake and output should be monitored, along with the number, color, and consistency of stools.
The individual with malabsorption syndrome must be monitored for dehydration, including dry tongue, mouth and skin; increased thirst; low, concentrated urine output; or feeling weak or dizzy when standing. Pulse and blood pressure should be monitored, observing for increased or irregular pulse rate, or hypotension (low blood pressure). The individual should also be alert for signs of nutrient, vitamin, and mineral depletion, including nausea or vomiting; fissures at corner of mouth; fatigue or weakness; dry, pluckable hair; easy bruising; tingling in fingers or toes; and numbness or burning sensation in legs or feet. Fluid volume excess, as a result of diminished protein stores, may require fluid intake restrictions. The physician should also be notified of any shortness of breath.
Other specific medical management for malabsorption syndrome is dependent upon the cause. Treatment for tropical sprue consists of folic acid supplements and long-term antibiotics. Depending on the severity of the disorder, this treatment may be continued for six months or longer. Whipple's disease also may require long-term use of antibiotics, such as tetracycline. Management of some individuals with malabsorption syndrome may require injections of vitamin B12 and oral iron supplements. The doctor may also prescribe enzymes to replace missing intestinal enzymes, or antispasmodics to reduce abdominal cramping and associated diarrhea. People with cystic fibrosis and chronic pancreatitis require pancreatic supplements. Those with lactose intolerance or gluten enteropathy (non-tropical sprue) will have to modify their diets to avoid foods that they cannot properly digest.
— Kathleen D. Wright, RN
