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Causes of malabsorption in the elderly.

R D Montgomery, N Y Haboubi, N H Mike

    Age and Ageing
    |July 1, 1986
    PubMed
    Summary

    Malabsorption in older adults often has multiple causes, including pancreatic insufficiency and postgastrectomy syndrome. Gastric atrophy, leading to vitamin B12 deficiency, is a key factor in unexplained malabsorption and bacterial overgrowth.

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    Area of Science:

    • Gastroenterology
    • Geriatric Medicine
    • Internal Medicine

    Background:

    • Malabsorption is a complex condition with diverse etiologies.
    • Older adults present unique challenges in diagnosing malabsorption.
    • Identifying underlying causes is crucial for effective management in the elderly.

    Purpose of the Study:

    • To investigate the pathogenesis of malabsorption in patients over 65 years old.
    • To identify the various contributing factors to malabsorption in this age group.
    • To explore the role of bacterial overgrowth and vitamin B12 deficiency.

    Main Methods:

    • Study included 70 patients aged over 65 referred to a special investigative unit.
    • Diagnostic evaluation included assessment for pancreatic insufficiency, postgastrectomy syndrome, small-bowel diverticulosis, and celiac disease.
    • Analysis of enterobacterial overgrowth and vitamin B12 levels was performed.

    Main Results:

    • Multiple causes of malabsorption were frequently observed.
    • Pancreatic insufficiency, postgastrectomy syndrome, and small-bowel diverticulosis were common.
    • Eight patients were diagnosed with celiac disease, and 15 had anatomically normal small bowels, with 10 showing vitamin B12 deficiency.

    Conclusions:

    • Enterobacterial overgrowth is prevalent in most malabsorption groups, excluding pancreatic and celiac disease.
    • Vitamin B12 deficiency can be both a cause and effect of malabsorption.
    • Gastric atrophy, pernicious anemia, and vitamin B12 deficiency appear to be significant factors in elderly malabsorption, potentially creating a vicious cycle.

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