Common malabsorption syndromes in different pediatrics age

Mohammed Saeed Babonji, Lujain Samir Asiri, Samia Mhros Alamri, Ghada Ibrahim Ajwa, Raghd Khalid Alsoliman, Lubna Nabil Ismail, Anmar Khalid Aljuhani, Albraa Mohammed Bogis, Sahar Abdulrahman Alyamani, Sajidah Bader Alsaif, Batool Khalid Alsarhan, Abdulghani Abdulaziz Alzamzami


The process of digestion involve many organs that include the small intestine, pancreas, gall bladder, related blood vessels and lymphatics. The small intestine which constitutes a large surface area of the gastrointestinal tract (GIT). The presence of the villi, absorptive spaces and enzymes directly contribute to the absorption of almost all elements. On the contrary, malabsorption syndromes is a condition that prevent the absorption of certain nutrients and fluids. Our present literature review mainly aimed to discuss the common malabsorption syndromes and their related etiologies in pediatric patients. We have classified our discussion based on the deficient nutrients for easy delivery and based on the specification of the etiology per each nutrient. Many studies have shown that some disease have been previously commonly reported with the development of different malabsorption syndromes such as inflammatory bowel diseases, celiac disease, autoimmune enteropathies and other congenital disorders. Furthermore, patients with malabsorption syndromes usually present with diarrhoea, steatorrhea and other GIT symptoms such as idiopathic pain and flatulence, but there are no specific symptoms associated with any of these syndromes. Efforts should be directed to understand more about the pathophysiology of some disorders, especially the congenital and idiopathic ones in order to achieve a better management and to enhance the prognosis of the affected patients.


Malabsorption, Pediatric, Gastrointestinal, Diarrhea

Full Text:



Keller J, Layer P. The pathophysiology of malabsorption. Viszeralmedizin. 2014;30(3):150-4.

vanderHeide F. Acquired causes of intestinal malabsorption. Best Pract Res Clin Gastroenterol. 2016;30(2):213-24.

Montalto M, Santoro L, D'Onofrio F, Curigliano V, Visca D, Gallo A, et al. Classification of malabsorption syndromes. Dig Dis. 2008;26(2):104-11.

Jayawardena D, Alrefai WA, Dudeja PK, Gill RK. Recent advances in understanding and managing malabsorption: focus on microvillus inclusion disease. F1000Res. 2019;8:1000.

Nikaki K, Gupte GL. Assessment of intestinal malabsorption. Best Pract Res Clin Gastroenterol. 2016;30(2):225-35.

Mziray-Andrew CH, Sentongo TA. Nutritional deficiencies in intestinal failure. Pediatr Clin North Am. 2009;56(5):1185-200.

Konturek PC, Brzozowski T, Konturek SJ. Stress and the gut: pathophysiology, clinical consequences, diagnostic approach and treatment options. J Physiol Pharmacol. 2011;62(6):591-9.

Pironi L. Definitions of intestinal failure and the short bowel syndrome. Best Pract Res Clin Gastroenterol. 2016;30(2):173-85.

Diamanti A, Calvitti G, Martinelli D, Santariga E, Capriati T, Bolasco G, et al. Etiology and Management of Pediatric Intestinal Failure: Focus on the Non-Digestive Causes. Nutrients. 2021;13(3):786.

Owens SR, Greenson JK. The pathology of malabsorption: current concepts. Histopathol. 2007;50(1):64-82.

Clark R, Johnson R. Malabsorption syndromes. Nurs Clinic North Am. 2018;53(3):361-74.

Goodman BE. Insights into digestion and absorption of major nutrients in humans. Adv Physiol Ed. 2010;34(2):44-53.

Rinawi F, Iancu TC, Hartman C, Cohen H, Yarden-Bilavsky H, Lev MRB, et al. Fat malabsorption due to bile acid synthesis defect. Isr Med Assoc J. 2015;17(3):190-2.

Rowe K, Pankow J, Nehme F, Salyers W. Gastrointestinal amyloidosis: review of the literature. Cureus. 2017;9(5):1228.

Shah R, John S. Cholestatic jaundice. Treasure Island (FL): StatPearls Publishing; 2021.

Fujimori S. What are the effects of proton pump inhibitors on the small intestine? World J Gastroenterol. 2015;21(22):6817-9.

Thieu H, BachDat B, Nam NH, Reda A, Duc NT, Alshareef A, et al. Antibiotic resistance of Helicobacter pylori infection in a children's hospital in Vietnam: prevalence and associated factors. Minerva Medica. 2020;111(5):498-501.

Vignes S, Bellanger J. Primary intestinal lymphangiectasia (Waldmann's disease). Orphanet J Rare Dis. 2008;3:5.

Kakiuchi T, Mizuochi T, Koji A, Zhang Y, Sakata Y. Long-term endoscopic findings in pediatric primary intestinal lymphangiectasia. Clin Case Rep. 2020;9(2):1029-30.

Elchert JA, Mansoor E, Abou-Saleh M, Cooper GS. Epidemiology of Whipple's disease in the USA between 2012 and 2017: a population-based national study. Digest Dis Sci. 2019;64(5):1305-11.

Monstein HJ, Folkesson R. Phorbol 12-myristate-13-acetate (PMA) stimulates a differential expression of cholecystokinin (CCK) and c-fos mRNA in a human neuroblastoma cell line. FEBS. 1991;293(1-2):145-8.

Lember M. Hypolactasia: a common enzyme deficiency leading to lactose malabsorption and intolerance. Polskie Archiwum Medycyny Wewnetrznej. 2012;122(1):60-4.

Fernández-Bañares F, Monzón H, Forné M. A short review of malabsorption and anemia. World J Gastroenterol. 2009;15(37):4644-52.

Garnier-Lengliné H, Cerf-Bensussan N, Ruemmele FM. Celiac disease in children. Clinic Res Hepatol Gastroenterol. 2015;39(5):544-51.

Tully MA. Pediatric celiac disease. Gastroenterol Nurs. 2008;31(2):132-40.

Santiago-Borrero PJ, Maldonado N, Horta E. Tropical sprue in children. J Pediat. 1970;76(3):470-9.

Mathew K, Ignatius M, Meenakshiammal, Baker SJ. Tropical sprue in children. Ind Pediatr. 1964;1:271-5.

Mathan VI, Joseph S, Baker SJ. Tropical sprue in children: a syndrome of idiopathic malabsorption. Gastroenterol. 1969;56(3):556-70.

Ahmed Z, Imdad A, Connelly JA, Acra S. Autoimmune enteropathy: an updated review with special focus on stem cell transplant therapy. Digest Dis Sci. 2019;64(3):643-54.

Chen CB, Tahboub F, Plesec T, Kay M, Radhakrishnan K. A review of autoimmune enteropathy and its associated syndromes. Digest Dis Sci. 2020;65(11):3079-90.

Kim S, Ferry G. Inflammatory bowel diseases in children. Curr Prob Pediatr Adolesc Heal Care. 2002;32(4):108-32.

Kelsen J, Baldassano RN. Inflammatory bowel disease: the difference between children and adults. Inflamm Bowel Dis. 2008;14(2):9-11.

Wang V, Dorfman DM, Grover S, Carr-Locke DL. Enterocolic fistula associated with an intestinal lymphoma. Med Gen Med. 2007;9(1):28.

Haack CI, Galloway JR, Srinivasan J. Enterocutaneous Fistulas: a look at causes and management. Curr Surg Rep. 2014;2(10):71.

Tremlett H, Waubant E. Gut microbiome and pediatric multiple sclerosis. Mult Scler. 2018;24(1):64-8.

Chu F, Shi M, Lang Y, Shen D, Jin T, Zhu J, et al. Gut microbiota in multiple sclerosis and experimental autoimmune encephalomyelitis: current applications and future perspectives. Mediators of Inflamm. 2018;2018:8168717.

Duro D, Kamin D, Duggan C. Overview of pediatric short bowel syndrome. J Pediatr Gastroenterol Nutrition. 2008;47(1):33-6.

Nistor N, Ciontu L, Frasinariu OE, Lupu VV, Ignat A, Streanga V. Acrodermatitis enteropathica: a case report. Med (Balti). 2016;95(20):3553.

Zeriouh L, Hali F, Khadir K, Benchikhi H. Acrodermatitis enteropathica-like disease in a full-term exclusively breast-fed infant. Archives de pediatrie : organe officiel de la Societe francaise de pediatrie. 2013;20(10):1129-32.

Abdullah AM, El-Mouzan MI, El Shiekh OK, AlMazyad A. Congenital glucose-galactose malabsorption in Arab children. J Pediatr Gastroenterol Nutrition. 1996;23(5):561-4.

Wright EM. Glucose galactose malabsorption. American J Physiol-Gastrointest Liver Physiol. 1998;275(5):879-82.

Mazigh S, Yahiaoui S, BenRabeh R, Fetni I, Sammoud A. Diagnosis and management of cow's protein milk allergy in infant. La Tunisie medicale. 2015;93(4):205-11.