1. Stools may appear normal even when laden with excess fat. |
2. Patients with carbohydrate malabsorption may have watery diarrhea and complain of excess flatus and abdominal distension. Symptoms typically occur within 90 minutes of carbohydrate ingestion. |
3. Abdominal pain is unusual in malabsorption except in the case of selected diseases (eg, chronic pancreatitis, Crohn disease, or intestinal pseudo-obstruction). |
4. Patients with celiac disease often have a childhood history of ill health and a positive family history of gluten sensitivity or Crohn disease. A subtle presentation, such as anemia or mildly elevated liver enzymes, is commonly the sole initial indication of disease. |
5. The prevalence of celiac disease in patients with type 1 diabetes mellitus is higher than the general population. |
6. Always ask about previous abdominal surgery. |
7. Always ask about a history of recurrent peptic ulcer disease. |
8. Do not forget to ask about alcohol consumption. It usually takes 10 to 20 years for pancreatic insufficiency to develop in alcoholics. |
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