(MAC/MAI) Mycobacterium Avium Complex Pulmonary Disease: Join us

@flib Do try small/frequent mini meals/snacks. Fat is the most concentrated source of calories, so using nuts and seeds, nut butters, avocado, oils,butter to your foods can help.

@alleycatkate The Discussion Board has a list of topics - check it out.

@milagro103 You are in good hands at Mayo, that is where I go.

@milagro103 Eva, does your husband have a primary disease? An underlying one that left him suseptable to mac?

@suzie2017 I think it depends on the individual. My mom was always a slender woman, but at het end stage of emphesyma & COPD she was stout due to enlarging lungs and years of being on prednisone. She was 58 yrs old when she passed. She had the added burden of Alpha-, a genetic disease. I am feeling for your husband; lung disease is no picnic.

@tdrell Your friend at least has a sense of humor along with her earlobes!

Factors that may cause malabsorption syndrome include:

damage to the intestine from infection, inflammation, trauma, or surgery
prolonged use of antibiotics
other conditions such as celiac disease, Crohn’s disease, chronic pancreatitis, or cystic fibrosis
lactase deficiency, or lactose intolerance
certain defects that are congenital (present at birth), such as biliary atresia (when the bile ducts don’t develop normally and prevent the flow of bile from the liver)
diseases of the gallbladder, liver, or pancreas
parasitic diseases
radiation therapy, which may injure the lining of the intestine
certain drugs that may injure the lining of the intestine, such as tetracycline, colchicine, or cholestyramine
The syndrome may also be caused by digestive problems. Your stomach may not be able to produce the enzymes it needs to digest certain foods. Or your body may not be able to mix the food you eat with the enzymes and acid produced by your stomach.

Rare causes
There are also some uncommon disorders that can result in malabsorption. One of these is called short bowel syndrome (SBS). With this condition, the small intestine is shortened. This makes the intestine less able to absorb nutrients. SBS may be a birth defect, or it may be caused by surgery.

Certain diseases may cause malabsorption. These include tropical sprue, a condition most common in the Caribbean, India, and other parts of Southeast Asia. This disease may be related to environmental factors, such as toxins in food, infection, or parasites. An even rarer potential cause of malabsorption is Whipple’s disease, which is a result of a bacterial infection.

Recognizing the symptoms of malabsorption syndrome
Symptoms of malabsorption syndrome are caused when unabsorbed nutrients pass through the digestive tract.

Many symptoms differ depending on the specific nutrient or nutrients that are not being absorbed properly. Other symptoms are a result of a deficiency of that nutrient, which is caused by its poor absorption. For instance, you may have the following symptoms if you’re unable to absorb fats, protein, or certain sugars or vitamins:

Fats: You may have light-colored, foul-smelling stools that are soft and bulky. Stools are difficult to flush and may float or stick to the sides of the toilet bowl.
Protein: You may have dry hair, hair loss, or fluid retention. Fluid retention is also known as edema, and will manifest as swelling.
Certain sugars: You may have bloating, gas, or explosive diarrhea.
Certain vitamins: You may have anemia, malnutrition, low blood pressure, weight loss, or muscle wasting.
Malabsorption may affect people based on age or gender. For instance, women may stop menstruating, and children may not grow properly. Their weight or rate of weight gain may be significantly below that of other children of a similar age and gender. Another sign of malabsorption in children is that they may purposefully avoid certain foods.

Risk factors
Risk factors for malabsorption syndrome include:

a family history of cystic fibrosis or malabsorption
drinking large amounts of alcohol
intestinal surgery
use of certain medications, including laxatives or mineral oil
travel to the Caribbean, India, and other parts of Southeast Asia
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Diagnosing malabsorption syndrome
Your doctor may suspect malabsorption syndrome if you have chronic diarrhea or nutrient deficiencies, or have lost a significant amount of weight despite eating a healthy diet. Certain tests are used to confirm the diagnosis. These tests may include:

Stool tests
Stool tests can measure fat in samples of stool (feces). These tests are the most reliable because fat is usually present in the stool of someone with malabsorption syndrome.

Blood tests
These tests measure the level of specific nutrients in your blood, such as vitamin B-12, vitamin D, folate, iron, calcium, carotene, phosphorus, albumin, and protein. A lack of one of these nutrients may not necessarily mean you have malabsorption syndrome. It can mean you are not choosing foods with healthy levels of nutrients. Normal levels of these nutrients suggest that malabsorption is not the problem.

Breath tests
Breath tests can be used to test for lactose intolerance. If lactose is not being absorbed, it enters the colon. Bacteria in the colon break down the lactose and produce hydrogen gas. The excess hydrogen is absorbed from your intestine, into your bloodstream, and then into your lungs. You will then exhale the gas.

If you have hydrogen gas in your breath after ingesting a product containing lactose, you may have lactose intolerance.

Imaging tests
Imaging tests, which take pictures of your digestive system, may be done to look for structural problems. For instance, a CT scan may be done to look for thickening of the wall of your small intestine, which could be a sign of Crohn’s disease.

Biopsy
You may have a biopsy if your doctor suspects that you have abnormal cells in the lining of your small intestine. This test will likely be done using an endoscopy. A tube is inserted into your mouth and sent through your esophagus and stomach and into your small intestine, where it takes a small sample of cells.

Treatment options for malabsorption syndrome
Your doctor will likely start your treatment by addressing symptoms such as diarrhea. Medications such as loperamide can help.

Your doctor will also want to replace the nutrients and fluids that your body has been unable to absorb. And they may monitor you for signs of dehydration, which can include increased thirst, low urine output, and dry mouth, skin, or tongue.

Next, your doctor will provide care based on the cause of the absorption problem. For instance, if you’re found to have lactose intolerance, your doctor will likely advise you to avoid milk and other dairy products or take a lactase enzyme tablet.

At this point, your doctor may refer you to a dietitian. Your dietitian will create a treatment plan that will help make sure you’re getting the nutrients your body needs. Your dietitian may recommend:

Enzyme supplements: These supplements can help your body absorb the nutrients it can’t absorb on its own. Find a great selection of enzyme supplements here.
Vitamin supplements: Your dietitian may recommend high doses of vitamins or other nutrients to make up for those that are not being absorbed by your intestine.
Diet changes: Your dietitian may adjust your diet to increase or decrease certain foods or nutrients. For instance, you may be advised to avoid foods high in fat to decrease diarrhea, and increase foods high in potassium to help balance your electrolytes.
Your doctor and your dietitian can help create a treatment plan that will manage your malabsorption symptoms and allow your body to obtain the nutrients and fluids it needs to function normally.

Possible complications
Q:
What are the long-term complications of malabsorption syndrome?

A:
Complications are directly related to the type of nutrient not being absorbed. In some cases, people get persistent diarrhea, weight loss, and abdominal pain. Vitamin deficiencies can cause conditions such as anemia, numbness in the hands or feet, and memory problems.

Treatment for malabsorption syndrome is very important. The body needs to receive the proper nutrients in the proper proportions in order for it to function correctly. Missing vital nutrients can affect every system in the body including the heart, brain, muscles, blood, kidney, and skin. Children and the elderly are especially sensitive to these problems.

Judith Marcin, MD
Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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Medically reviewed by University of Illinois-Chicago, College of Medicine on May 23, 2017 — Written by Michael Kerr and Jacquelyn Cafasso

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Thank you.

Thanks very much for this.

@unicorn, Wow, that was a long list! Weight loss and malabsorption is typical for mac infected individuals. I don't think we have to look very far for the reason it is happening. Thank you for looking that up as there are other reasons too that people experience this.