Malabsorption: The impaired absorption by the intestines of nutrients from food. Malabsorption can be specific and involve sugars, fats, proteins, or vitamins. Alternatively, malabsorption can be general and nonspecific. The causes of malabsorption include cystic fibrosis (from lack of pancreatic enzymes to digest food), lactose intolerance, celiac disease (gluten-induced-enteropathy, sprue), Whipple disease, acrodermatitis enteropathica (zinc malabsorption), biliary atresia, pernicious anemia, and the parasites Giardia lamblia (giardiasis), Strongyloides stercoralis (threadworm), and Necator americanus (the hookworm). The signs and symptoms depend on the type of malabsorption and may include failure to thrive (in infancy and childhood), diarrhea, cramping, frequent bulky stools, bloating, flatulence (gas), and abdominal distention. Treatment depends on the exact cause. Basically Fructose Malabsorption is a condition where fructose, a simple sugar molecule, is not absorbed properly in the small intestine. It moves through to the large intestine where bacteria munch away on it. When the bacteria digest fructose it produces the symptoms of malabsorption. The degree of malabsorption can vary from individual to individual. Some people are very sensitive. Malabsorption means that the nutrients from foods are not getting absorbed into the body properly. Digestion and absorption are long complicated processes. Chewing and enzymes in saliva help to get the process started. Acid is secreted in the stomach to start the digestion process. If there is insufficient stomach acid, betaine HCl will help to replace the acid. Enzymes function best in a narrow range of pH, so the extra acid will help to get the pH closer to where it is supposed to be so that the enzymes can do their job. There can also be insufficient enzymes. Adding digestive enzymes will help. Animal derived ones are closer to what a human would normally produce, and are better for this. With sufficient stomach acid and digestive enzymes the food gets broken down more like it is supposed to and will therefore be less damaging to the cells of the intestine. The cells lining the intestines can be damaged and that will greatly interfere with their ability to do the final breaking down of nutrients to components and absorb them. Modifying the diet so that foods are more readily digested and absorbed, and adding supplements to nourish those cells will help them to heal. Malabsorption can cause lots of things depending on what nutrients are in short supply. Lactose intolerance is the inability to digest the sugar lactose (which is present in all dairy products) because of a deficiency of the digestive enzyme lactase, leading to diarrhea and abdominal cramping. * Lactose intolerance is caused by a lack of the enzyme lactase. * Children have diarrhea and may not gain weight, whereas adults have abdominal bloating, cramps, diarrhea, flatulence, nausea, audible bowel sounds (borborygmi), and an urgent need to have a bowel movement. * The diagnosis is based on recognizing that symptoms occur after a person has consumed dairy products. * Treatment involves taking supplemental lactase enzymes and avoiding lactose, particularly in dairy products. Lactose, the predominant sugar found in milk and other dairy products, is broken down by the enzyme lactase, which is produced by the cells in the inner lining of the small intestine. Lactase breaks down lactose, a complex sugar, into its two components, glucose and galactose. These simple sugars are then absorbed into the bloodstream through the intestinal wall. If lactase is lacking, lactose cannot be digested and absorbed. The resulting high concentration of lactose draws fluid into the small intestine, causing diarrhea. The unabsorbed lactose then passes into the large intestine, where it is fermented by bacteria, resulting in flatulence and acidic stool. Lactase levels are high in infants, permitting them to digest milk. However, in most ethnic groups (80% of blacks and Hispanics, almost 100% of Asians), lactase levels decrease after weaning. These decreased levels mean that older children and adults in these ethnic groups are unable to digest much lactose. However, 80 to 85% of whites of Northwest European descent produce lactase throughout life and are thus able to digest milk and milk products as adults. Therefore, because of the ethnic composition of the U.S. population, it is likely that between 30 million and 50 million people in the United States are lactose intolerant. It is interesting to note that this "intolerance" is really the normal state for more than 75% of the world's population. In tolerances to other sugars can also occur but are relatively rare. For example, a lack of the enzyme sucrase prevents the sugar sucrose from being absorbed into the bloodstream, and a lack of the enzymes maltase and isomaltase prevents the sugar maltose from being absorbed into the bloodstream. Symptoms People with lactose intolerance usually cannot tolerate milk and other dairy products, all of which contain lactose. Some people recognize this early in life and consciously or unconsciously avoid dairy products. A child who is lactose intolerant has diarrhea and may not gain weight when milk is part of the diet. An adult may have abdominal bloating, cramps, diarrhea, flatulence, nausea, audible bowel sounds (borborygmi), and an urgent need to have a bowel movement between 30 minutes and 2 hours after eating a meal containing lactose. For some people, severe diarrhea may prevent proper absorption of nutrients because they are expelled from the body too quickly. However, the symptoms that result from lactose intolerance are usually mild. In contrast, symptoms that result from malabsorption in such conditions as celiac disease, tropical sprue, and infections of the intestine are more severe. Diagnosis and Treatment A doctor suspects lactose intolerance when a person has symptoms after consuming dairy products. If a 3- to 4-week trial period of a diet free of dairy products eliminates the symptoms, the diagnosis is confirmed. Specific tests are rarely necessary. Lactose intolerance can be controlled through diet by avoiding foods containing lactose, primarily dairy products. Lactase enzymes are available in liquid and tablet forms without a prescription and can be added to milk. Lactose-reduced milk and other products are available at many supermarkets. People who must avoid dairy products should take calcium supplements to prevent calcium deficiency.