Page 163 - Color Atlas Of Pathophysiology (S Silbernagl Et Al, Thieme 2000)

A. Sites of Absorption of Potentially Malabsorbed Substances

Proximal duodenum: monosaccharides

Inflow of bile and pancreatic juice
Distal duodenum: disaccharides, fat-soluble vitamins,
Fe, Ca 2+ Malabsorption I
Jejunum: Proteins (as amino acids), starch (as glucose),
water-soluble vitamins
Ileum: fats
Maldigestion and
Terminal ileum: bile salts, cobalamines

B. Steps in Digestion the Failure of which Leads to Malabsorption
Nutrients
Processing
Luminal Stomach Plate 6.10
digestion Enzymes in
lumen
Mucosal Bile Pepsins, Brush border
HCl
digestion salts enzymes
Duodenum Pancreas
Carrier
Absorption
–
Enzymes, HCO 3 Mucosal cell
Mucosal
processing Lymph
Blood
Removal
C. Causes and Consequences of Malabsorption (see also D.)
Chronic pancreatitis, Specific
pancreas carcinoma carrier defect
(Hartnup, cystinuria)
Gastrinoma Lymphangiectasia
Disaccharidase
Gastrectomy, Achlorhydria deficiency Global defects
gastric resection, Bacteria in small intestine (e.g. lactase) (e.g. resection, sprue, Ischemia,
vagotomy Crohn’s) vasculitis
Malabsorption of
2+
Proteins Carbohydrates Zinc Iron Cobalamine Folate Ca , Mg 2+
Edema Bacterial splitting of Taste Anemia, glossitis, etc. Tetany
carbohydrates in colon
Weight Wound-
loss healing Paresthesias
Muscle Flatulence Watery Acro-
wasting diarrhea dermatitis 153

Silbernagl/Lang, Color Atlas of Pathophysiology © 2000 Thieme
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