Our cells need nutrients to perform vital bodily functions and keep us alive. When we eat and drink, it is our digestive system’s job to break down, absorb, and transmit essential nutrients to cells throughout the body. However, when one or more steps in this complex process fail, the food remains unabsorbed.

This article explains what causes nutrient malabsorption, how it affects our bodies, and how to treat the symptoms and triggers.

What Is Nutrient Malabsorption?

Nutrient malabsorption is the impaired ability of the gastrointestinal tract to absorb nutrients, usually due to dysfunction of the small intestine, where most nutrient absorption occurs. Other digestive organs that can be responsible for malabsorption include the pancreas, gallbladder, liver, and stomach.

Unabsorbed food moves to the large intestine, where it is fermented by bacteria or directly excreted through stool. Uncomfortable symptoms usually follow the elimination of unabsorbed nutrients. Long-term nutrient malabsorption can cause nutrient deprivation and lead to malnutrition.

What Nutrients Can Be Difficult to Absorb?

Patients can suffer from malabsorption of any macro or micronutrient. Macronutrients include fats, proteins, and carbohydrates. Micronutrients are vitamins and minerals.

Fat Malabsorption

Fats are broken down into essential fatty acids, which provide energy to cells and aid the absorption of crucial vitamins like vitamins A, D, K, and E. Lipid absorption is a complex process that involves lipolytic enzymes, bile salts, and intestinal transport mechanisms. A disruption in any step of the fat breakdown - in conditions such as pancreatic insufficiency, bile acid deficiency, or intestinal disorders - can lead to fat malabsorption.

Protein Malabsorption

Proteins are broken down into amino acids and absorbed into the bloodstream so the body can use them for building muscle and tissue repair. Certain conditions, such as cystic fibrosis and intestinal damage, impair protein digestion and absorption, but protein malabsorption alone is uncommon.

Carbohydrate Malabsorption

Our digestive system breaks down carbohydrates into monosaccharides (sugars like glucose, fructose, and galactose), which are absorbed into the bloodstream. Glucose is the primary monosaccharide because our cells use it as the main energy source.

Sometimes, the body lacks the enzymes needed to digest specific carbohydrates. One well-known example is lactase deficiency, which results in lactose malabsorption. People who suffer from this condition fail to properly digest lactose, a carbohydrate composed of glucose and galactose, which leads to symptoms such as bloating, diarrhea, and gas.

Vitamin and Mineral Malabsorption

Each vitamin and mineral has specific roles in our body, helping to carry out vital functions, including energy metabolism, oxygen transport, hormone regulation, and cognitive processes. Their absorption depends on properly functioning intestinal transport mechanisms and the digestion and absorption of other nutrients.

Dysfunctions like fat malabsorption and intestinal diseases can cause micronutrient malabsorption. Commonly affected vitamins and minerals include vitamins B1, B9, B12, D, K, calcium, iron, magnesium, selenium, and more.

Nutrient Malabsorption Symptoms

Nutrient malabsorption symptoms depend on the degree of malabsorption and which nutrients are affected. The symptoms include:

• Bloating
• Gas
• Flatulence
• Diarrhea
• Steatorrhea (fatty stool)
• Nausea
• Vomiting
• Unintentional weight loss
• Anemia
• Abdominal pain
• Edema (swelling)
• Dry skin
• Hair loss
• Night blindness
• Weakened bones
• Muscle pain
• Developmental delay (in children)
• Osteoporosis
• Increased bleeding of the gums and nose
• Fatigue
• Infertility

What Can Cause Nutrient Malabsorption?

Many medical problems can cause nutrient malabsorption, from congenital and acquired defects of the digestive system to infections and lifestyle habits.

Fat malabsorption causes include:

• Zollinger-Ellison syndrome
• Crohn’s disease
• Ulcerative colitis
• Celiac disease
• Small bowel resection
• Liver disease
• Small intestinal bacterial overgrowth
• Chronic pancreatitis
• Cystic fibrosis
• Pancreatic cancer
• Gastric surgery
• Lymphatic system disorders

Carbohydrate malabsorption occurs due to:

• Pancreatic amylase deficiency
• Lactase deficiency
• Sucrase deficiency
• Celiac disease
• Tropical sprue
• Crohn’s disease
• Ulcerative colitis
• Absolute loss of small intestinal mucosa
• Indigestion of unabsorbable carbohydrates (cellulose, sorbitol), etc.
• High consumption of processed, high-fructose products

The following conditions can cause protein malabsorption:

• Chronic pancreatitis
• Cystic fibrosis
• Inflammatory bowel disease
• Intestinal lymphangiectasia
• Bowel resection

Vitamin and mineral malabsorption causes include:

• Fat malabsorption
• Bariatric surgery
• Intestinal diseases and abnormalities
• Stomach diseases and abnormalities
• Medication overuse

Other causes of general malabsorption are:

• Autoimmune diseases (e.g., HIV/AIDS)
• Bacterial infections
• Alcohol abuse
• Surgery for obesity

Nutrient Malabsorption Risk Factors

Some people are more prone to nutrient malabsorption than others. Risk factors include:

• Family history of malabsorption
• Intestinal surgery
• High-fructose diet
• Alcohol abuse
• Certain medications (laxatives, antibiotics, corticosteroids, diuretics, etc.)

How Is Nutrient Malabsorption Diagnosed?

Nutrient malabsorption is sometimes apparent from a physical examination and a detailed review of the patient’s symptoms (their duration, timing, appearance, and severity), past medical history, family medical history, current therapies, and lifestyle habits.

In other cases, patients need more tests, including blood tests, stool analysis, imaging, endoscopy, and other diagnostics.

Physical Examination

The medical provider performs a full abdominal examination, inspecting potential hyper/hypoactive bowel sounds, abdominal distention, muscle wasting, abnormal reflexes, cardiac arrhythmia, poor wound healing, visual impairment, decreased cognitive ability, etc.

Blood Tests

Doctors use blood tests to evaluate nutrient deficiencies and support or discard a malabsorption diagnosis. The tests include:

• Complete blood cell count
• Albumin
• Minerals (e.g., magnesium, zinc, iron, phosphorus)
• Vitamins (e.g., B12, D, folate)
• Electrolytes, etc.

Stool Tests

They typically assess fat malabsorption syndromes. They can also detect parasites and bacteria that potentially cause malabsorption. Common tests include:

• Fecal fat – From a single stool.
• 72-hour fecal fat excretion – From a three-day specimen.
• Sudan III stain – From a spot stool sample.
• Acid steatocrit – Rapid test for steatorrhea.
• Near-infrared reflectance analysis (NIRA) – Simultaneously tests for fat, carbohydrates, and nitrogen.

Breath Tests

The presence of hydrogen or methane gas during a breath test suggests carbohydrate malabsorption or small intestinal bacterial overgrowth (SIBO). When unabsorbed sugars enter the colon, gut bacteria ferment them, producing hydrogen and methane gas, which can be detected in the breath.

More Specific Diagnostic Tests

Doctors use some of these diagnostics to confirm their diagnosis.

• Endoscopy – A small tube with a camera is inserted into the patient’s small intestine through the mouth and stomach. It can take a small sample of the tissue (biopsy). This test helps doctors detect Crohn’s disease, celiac disease, and other disorders of the lining of the small intestine.
• Colonoscopy – A flexible tube with a camera on its end is inserted into the patient’s large intestine to screen for potential causes of malabsorption, such as inflammatory bowel disease, ulcers, polyps, and cancer.
• Imaging – Tests like CT scans and MRIs provide pictures of the digestive system, helping detect signs of structural abnormalities and mucosal damage.

Can You Prevent Nutrient Malabsorption?

A nutritionally rich diet and limited alcohol intake promote a healthy gut microbiome and reduce the risk of nutrient malabsorption.

For individuals with a family history of intestinal diseases (such as celiac disease, Crohn’s disease, or colorectal cancer), early screening and lifestyle adjustments can help manage risk. In rare cases, preventive surgery may be considered for high-risk conditions like familial adenomatous polyposis (FAP) or severe Crohn’s disease complications.

However, many diseases that cause malabsorption develop unpredictably and may not always be preventable. Maintaining gut health through a balanced diet, stress management, and avoiding excessive antibiotic or NSAID use lowers the risk of digestive dysfunction.

Note: Learn more about gut dysbiosis and why it is important to maintain a healthy bacterial flora for overall health.

Nutrient Malabsorption Treatments

Treatments for nutrient malabsorption vary based on the cause and the severity of the symptoms. The therapy can focus on symptom relief, treatment of the underlying condition, and prevention of further health damage. Its success depends on establishing an accurate diagnosis.

Dietary Changes

A medical professional may prescribe a particular diet that eliminates certain foods potentially causing an intolerance and triggering malabsorption, such as lactose-containing dairy, sugary foods, etc. They may also recommend increasing the intake of other foods to ensure the patient receives the necessary nutrients.

Note: An anti-inflammatory diet is often recommended for people with food intolerances that can contribute to malabsorption.

Dietary Supplements

Patients with nutrient malabsorption can take dietary supplements to make up for lacking enzymes or lost nutrients. Doctors often prescribe digestive enzymes, probiotics and prebiotics, vitamins, minerals, and other gut-supporting nutrient combinations.

Our medical professionals at Vibrant Skin recommend Vibrant Digest for patients who experience occasional gas and bloating and need help with macronutrient digestion. Vibrant Gut Support is a more powerful combination of nutrients and provides comprehensive support for optimal gut health, healthy intestinal mucosal lining, healthy intestinal function, and reduced inflammatory response.

IV Therapy

IV therapy is an effective treatment for people with nutrient malabsorption and deficiencies. It enables faster and higher nutrient uptake, delivering lacking vitamins, minerals, amino acids, and other supplements directly to the bloodstream. IV therapy also rehydrates the body, improves immunity, increases energy, and provides other health benefits.

Medications

Doctors may prescribe medications to treat malabsorption symptoms and underlying medical conditions. Examples include antibiotics for infections and small intestinal bacterial overgrowth, corticosteroids and anti-inflammatory agents for Crohn’s disease, antispasmodic drugs to relax the intestinal tract, and anti-diarrhea medications.

What Happens If You Don’t Treat Nutrient Malabsorption?

Nutrient malabsorption is not a life-threatening disease. However, timely efforts to manage the symptoms prevent more severe conditions that can potentially develop due to nutritional deficiencies. They include:

• Growth delay in children
• Poor immunity
• Visual impairment
• Severe malnutrition
• Anemia
• Life-threatening electrolyte disturbances
• Bowel perforation
• Osteoporosis
• Neurological dysfunction
• Chronic fatigue
• Depression
• Dementia
• Anorexia
• Cardiac arrhythmias, etc.

When Should You Visit a Doctor?

If you experience symptoms of nutrient malabsorption, such as gas, bloating, chronic diarrhea, and fatty stools for an extended period, contact your healthcare provider. It is important to modify your lifestyle habits to alleviate gastrointestinal problems and seek timely medical help.

Conclusion

Nutrient malabsorption creates uncomfortable symptoms that can lead to more severe damage if not treated on time. Since various disorders can cause malabsorption, it is best to seek professional medical help to ensure proper treatment.

Our friendly team at Vibrant Vitality Clinic has vast experience managing digestive disorders. We can help you restore your gut health and a well-balanced, vibrant life.