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Location
Disease
Mechanism
Luminal
Exocrine pancreatic insufficiency
Lack of pancreatic enzymes (maldigestion)
Small-intestinal dysbiosis
Antibiotic-responsive diarrhea
Secondary small-intestinal bacterial overgrowth
Bacterial activity: bile salt deconjugation, fatty acid hydroxylation, competition for cobalamin and nutrients
Mucosal
Infectious enteropathies
Protozoal
Fungal
Hookworms
Chronic inflammatory enteropathy
Inflammatory bowel disease
Dietary sensitivity
Neoplastic infiltration
Mucosal damage: inflammation, brush border defects, disturbed enterocyte function, reduction of surface area
Villous atrophy
Reduction in surface area, immature enterocytes due to increased cell turnover with reduced brush border enzyme expression
Inherited and acquired brush border enzyme deficiencies
Lactase deficiency, diffuse small-intestinal disease
Postmucosal
Lymphangiectasia
Lymphatic obstruction impairs delivery of chylomicrons
Vasculitis, portal hypertension
Impaired delivery
