Stephen J. Schueler, M.D.

Overview Incidence Symptoms Evaluation Treatment questions for doctor specialist Home Care diarrhea in adults diarrhea in children diet taking control warning signs Outlook Complications Underlying Cause enzyme deficiency infections Anatomy

Malabsorption Syndrome Home Care

Home care for malabsorption includes:

  • Drink plenty of liquids.
  • Avoid laxatives.
  • Avoid dairy products.
  • Avoid foods that contain lactose.
  • Avoid foods that contain sorbitol.
  • Avoid foods that contain Olestra.
  • Soy formula for infants
  • Take anti-gas medications that contain simethicone:
  • Take your prescribed medications as directed:
    • Don't skip doses of your medication. This makes them less effective.
    • Avoid running out of your medication. Refill your prescriptions early.
    • Don't stop taking your medication just because you feel better.
    • If you feel worse, talk to your doctor before you stop your medication.
    • Be aware of the common side effects that may be caused by your medication.
    • Do not stop prescription medications without talking to your doctor.
  • Learn everything you can about malabsorption:
    • The more you know about your condition, the easier it will be to participate with your doctor in making treatment decisions.
    • Ask your doctor about good sources for information.
    • Write down questions to ask your doctor.

Malabsorption Syndrome Diarrhea in Adults

Home treatment for diarrhea in adults with malabsorption includes hydration and dietary therapy.

General Measures
Simple methods can restore lost body fluids and reduce symptoms. Adults who are taking fluids by mouth can usually restore lost fluids and body salts with oral rehydration therapy (ORT). Simply drinking enough fluid can treat most people with diarrhea and dehydration.

ORT fluids are usually used in children, but are also effective for adults. These include:

  • Infalyte
  • Lytren
  • Naturalyte
  • Pedialyte
  • Rehydralyte
  • ReVital
  • Generic drugstore brands

Adults may also use the following fluids:
  • Non-caffeinated soft drinks
  • Sports drinks
  • Tea
  • Water (not exclusively)

Dietary Therapy
It is not necessary to highly restrict the diet to treat diarrhea. Foods known to cause malabsorption should be avoided. Otherwise, most people can eat a regular diet. Small, frequent meals may improve symptoms.

Probiotic therapy with live Lactobacillus acidophilus cultures may help diarrhea by restoring the normal balance of intestinal bacteria. This is especially true after taking antibiotics.

Foods that may help diarrhea:
  • Applesauce
  • Bananas
  • Bread
  • Cereal
  • Crackers (saltines and pretzels contain needed salt)
  • Lean meats
  • Mashed potatoes
  • Noodles
  • Oatmeal
  • Oral rehydration therapy liquids
  • Potatoes
  • Rice
  • Sorghum
  • Strained carrots
  • Wheat
  • Yogurt with live cultures

Items that may worsen diarrhea include:
  • Alcohol
  • Caffeine
  • Concentrated fruit juices
  • High-sugar foods (junk food)
  • Cow's milk
  • Spicy foods
  • Sugar substitutes

Malabsorption Syndrome Diarrhea in Children

Home treatment of diarrhea in children with malabsorption includes hydration and dietary therapy.

Those who are able to drink liquids can restore lost water and salt with oral rehydration therapy (ORT).

ORT fluids used in children include:

  • Infalyte
  • Lytren
  • Naturalyte
  • Pedialyte
  • Rehydralyte
  • ReVital
  • Generic drugstore brands

Additional ORT fluids for older children include:
  • Soft drinks without caffeine
  • Sports drinks (Gatorade)
  • Tea
  • Water

Strategies for breast-fed infants under 6 months include:
  • Continue breast feeding as much as your baby desires.
  • Provide additional ORT fluids to supplement breast milk.
  • If vomiting occurs, provide small amounts of ORT fluids every 30-60 minutes.
  • Prevent diaper rash by changing diapers frequently and apply Vaseline to the skin.
  • Watch for symptoms of dehydration.

Strategies for bottle-fed infants under 6 months:
  • Give your child normal amounts of formula.
  • Provide as much ORT fluids as your baby desires.
  • If vomiting occurs, provide small amounts of ORT fluids every 30-60 minutes.
  • If vomiting occurs, try a lactose-free formula.
  • Prevent diaper rash by changing diapers frequently and apply Vaseline to the skin.
  • Watch for symptoms of dehydration.

Strategies for children over 6 months:

Dietary Therapy
ORT is most important if you have vomiting with the diarrhea. Once vomiting and nausea resolves, provide bland foods first. If bland foods are tolerated, then you resume a normal diet.

Foods that may help diarrhea:
  • Applesauce
  • Bananas
  • Bread
  • Cereal
  • Crackers
  • Mashed potatoes
  • Noodles
  • Oatmeal
  • Potatoes
  • Rice
  • Strained carrots
  • Wheat
  • Yogurt

Items that may worsen diarrhea include:
  • Alcohol
  • Caffeine
  • Concentrated fruit juices
  • High-sugar foods junk food
  • Cow's milk
  • Spicy foods
  • Sugar substitutes

Malabsorption Syndrome Diet

Malabsorption can prevent the body from receiving important nutrients. Foods known to cause symptoms should be avoided. Otherwise, a generally healthy diet should be followed.

Strategies for a healthy diet include:

  • Limit your intake of fat to 30% of your total calories.
  • 10% to 15% of your total calories should be in the form of monounsaturated fats, such as olive oil, canola oil and peanut oil.
  • Consume only unsaturated fats that are low in cholesterol.
  • Consume less than 300 milligrams of cholesterol a day.
  • Eat dietary fiber: whole grains are best.
  • Avoid fad diets.
  • Check with your doctor about B vitamin supplements. Some people may benefit from B vitamins.

Key Dietary Recommendations for Chronic Disease Prevention
Energy (calories)to maintain BMI < 25
Total fats< or = to 30% of total daily calories
Saturated fats< 7% of total daily calories
Polyunsaturated fats< 10% of total daily calories
Monounsaturated fats< 13% of total daily calories
Cholesterol< or = to 300 mg per day
Dietary fiber25-30 grams per day
Fiber type3:1 insoluble to soluble fiber
Sodium< or = to 1,500 mg per day
Calcium 9-24 yrs1,200-1,500 mg per day
Calcium 25-50 yrs1,000 mg per day
Calcium 51-65 yrs1,200 mg per day
Calcium >65 yrs1,500 mg per day
Vitamin D 9-50 yrs200 IU per day
Vitamin D 51-70 yrs400 IU per day
Vitamin D >70 yrs600 IU per day
Folic acid400 micrograms (ug) per day
Fruits & vegetables5-7 servings per day
Alcohol (men)< or = to 2 drinks per day
Alcohol (women)< or = to 1 drink per day

Malabsorption Syndrome Taking Control

The successful treatment of malabsorption requires your participation. Here are answers to some important questions.

Do you have control over your health and wellness?
Many people believe they have no control over their health and wellness. Many ignore personal health decisions or simply leave them to their doctors, relatives, or friends. In reality, you have the greatest potential to determine your relative health.

How is this possible? Do people really have control of their own health? The biggest killers are heart disease and cancer. Although many of these diseases seem to strike at random, our lifestyle choices greatly influence personal risk.

How can you participate in your health care?
To participate you must:

  • Learn to take responsibility for your own health.
  • Learn to partner with your doctor.
  • Learn how to make active decisions about your health.

How can you learn what you need to know?
  • Educate yourself.
  • Be skeptical: Learn to separate fact from fiction.
  • Billions of dollars are spent each year marketing dietary supplements, vitamins, and new medical treatments. Much of this is unnecessary and wasteful.
  • Be careful about where you get your health information.
    • Some of the best sources for health information on the web are professional societies and non-profit organizations.
    • Ask your doctor what he or she recommends.
  • Examine the credentials of the authors.
    • If you are reading about symptoms and disease, your best source is a licensed physician.
    • Pay attention to when the content was last updated.
    • Make sure the person is not just trying to sell you something.

Important questions you need to answer:
  • What things in your control can increase your risk for disease?
  • What can you do to decrease this risk?
  • What are vaccines and how can they help you?
  • How do your lifestyle choices increase your risk for disease?
  • How can you reduce stress?
  • What minor health problems can you treat at home?
  • When is a medical problem "serious"?
  • When should you call the doctor?

How can you find the right doctor?
Key points:
  • Everyone should have a primary care physician or family doctor. A primary physician is usually a family practitioner, internist, or pediatrician.
  • Establish a relationship in advance with your doctor.
  • Make sure you are comfortable with your primary care physician.
  • The internet contains many resources where you can do research to locate the doctor that is best for you.
  • You may wish to schedule a brief visit with the doctor to see if he or she is right for you.
    • Be open-minded, and allow your doctor to know you well. This will improve communication.

Important information you need to make your decision:
  • Physician credentials:
    • Internship and residency training is usually best from respected institutions, universities, and major hospitals.
    • Look for board certification in the specialty.
    • Ask about membership in medical societies.
  • Community and professional reputation are also important.
    • Are other patients happy with the doctor?
    • Has the doctor been disciplined by hospitals or agencies?
    • How long has the doctor been in practice?
    • In general, more than a few malpractice suits over a 5-10 year period should trigger caution.
  • Does the doctor communicate well? Are your questions answered during busy times?
  • Does the doctor welcome you to help make decisions about your care?
  • Is the doctor available when you need care?
  • What is the doctor's after-hours coverage?
  • Is he or she a member of a large group?
    • Do the doctors' cross-cover one another?
  • Where do they admit patients?

What is shared decision making?
You and your doctor must work together to jointly decide the best course of action to manage your health. This process is called "shared decision making". Your doctor becomes a guide and teacher and helps steer you toward the best treatment. Most doctors welcome this partnership. You must learn about your illnesses for shared decision-making to work.

For any recommended test, medication, or surgery, remember to ask:
  • How will this help me?
  • How much will it cost?
  • Is it covered by your insurance?
  • What are the potential side effects and risks?
  • What are my alternatives?

For tests, remember to ask:
  • Is it done in the office or at another facility?
  • Is it painful?
  • How will the results of this test influence my care?

For surgery or other procedures, remember to ask:
  • How long will it take to heal?
  • How many cases has the doctor done?
  • What would your doctor do if he or she were the patient?
  • Where is it done?
  • Who will perform it?
  • What are the doctor's qualifications?

What should you expect?
Shared decision making becomes impossible if you do not know what to expect from your doctor.

The American Hospital Association has published a "Patient's Bill of Rights" that is a good guide. It states that you have the right:
  • To be spoken to in words that you understand
  • To be told what's wrong with you
  • To know the benefits of any treatment and any alternatives
  • To know what a treatment or test will cost
  • To share in treatment decisions
  • To read your medical record
  • To refuse any medical procedure

What should you do before an office visit?
  • Bring all important medical information with you to the visit.
  • Make sure you can answer questions about the following:
    • Allergies and side effects to medicines
    • Current medicines you are taking. This includes herbs and vitamins. Make a list if necessary.
    • Insurance information
    • Marital and sexual history
    • Past injuries and hospital stays
    • Past medical problems
    • Past surgeries and operations
    • Pre-visit questionnaires
    • Use of tobacco, alcohol and drugs
    • Work history

What should you expect from the visit?
  • You should plan to wait if you go without an appointment. Emergencies or sick patients in the hospital may interrupt your doctor.
  • Bring along a book or toys for the kids. You may also have to wait during busy times.
  • Tell your doctor about your problem in a clear manner. Start from the beginning and go through each symptom as it appeared.
  • Before the visit, think about what makes your problem better or worse. Your doctor will probably ask you questions about this.
  • Most doctors ask many questions about unrelated symptoms. These questions help assure that there are no other problems that need attention.
  • Be sure to answer all questions truthfully. This includes sensitive questions about smoking, drug use, sexual activity, and work. Your history is the most important part of deciding what is wrong with you.
  • If you have any difficulty communicating your concerns, bring a family member or friend to assist in this task.
  • Talk to your doctor and do not leave the office without asking necessary questions. Your doctor can make you more comfortable if he or she understands your concerns.

What should you know about your medications?
Every year many people become ill because of problems with medications.

Remember to ask:
  • What side effects to expect.
  • What drug interactions are possible.
    • Find out if a new medicine reacts with those that you are taking now.
    • Many over-the-counter drugs and dietary supplements can also cause serious side effects and drug interactions.
    • Some drugs interact with certain foods, vitamins, nicotine, and alcohol.
  • Make sure you can drive or operate machines safely while taking a medicine.
  • Ask your doctor how much a prescription costs.
    • Is there a less expensive option or a generic version?

What is a treatment plan?
A treatment plan is what you and your doctor decide to do for an illness. A treatment plan cannot be effective without your participation.

Three simple questions can help you get the most from your treatment plan:
  • What is my main problem?
  • What do I need to do?
  • Why is it important for me to do these things?

Other important points:
  • Be sure you understand your treatment plan.
  • Stick with the treatment plan and allow time for improvement.
  • Don't stop medicines when you feel better; check with your doctor first.
  • Call your doctor if your condition is becoming worse.
  • Your doctor should tell you what to expect and when to follow-up or call the office.

Malabsorption Syndrome Warning Signs

Notify your doctor if you have malabsorption and any of the following:

Continue to Malabsorption Syndrome Outlook

Last Updated: Mar 11, 2011 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Malabsorption Syndrome References
  1. Farrell JJ. Overview and diagnosis of malabsorption syndrome. Semin Gastrointest Dis. 2002 Oct;13(4):182-90. [12462704]
  2. Ginsburg PM, Janefalkar P, Rubin DT, Ehrenpreis ED. Malabsorption testing: a review. Curr Gastroenterol Rep. 2000 Oct;2(5):370-7. [10998664]
  3. Salerno G, De Franco A, La Rosa S, Calistro V. Malabsorption syndromes. Rays. 2002 Jan-Mar;27(1):19-34. [12696272]
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