Malabsorptionssyndrome

Chronic diarrhea is a very frequent symptom, which can be caused by a variety of different diseases. Among others, it is a cardinal symptom of malabsorption syndromes. Carbohydrate intolerances are highly prevalent and, therefore, need to be considered primarily. Small intestinal bacterial overgrowth (SIBO) and pancreatic exocrine insufficiency also represent relevant causes of malabsorption syndromes. These disturbances can be diagnosed using specific tests of gastrointestinal function. However, prior to function tests, routine gastroenterological investigations should always be performed. If these are unrevealing and patients do not respond adequately to simple therapeutic measures, H₂-breath tests should be used for assessment of carbohydrate intolerances and SIBO. In the vast majority of cases, exocrine pancreatic function is investigated using fecal elastase measurements. The ¹³C-mixed triglyceride breath test represents an accepted but rarely available alternative.