Malabsorption syndrome : Studies on diagnosis and pathogenesis using 1 H NMR metabonomics approach

Abstract

High resolution NMR spectroscopy for the qualitative and quantitative estimation of metabolites in biofluids has become an important tool in biomedicine as it is non-destructive, doesn't require any chemical pre-treatment step, is highly selective and allows study of cellular biochemistry and metabolism. This article reviews such studies in urine and upper gut aspritate specimens of patients with Malabsorption Syndrome (MS) for the purpose of diagnosis and investigating pathogenesis of the disease. It has been demonstrated that 1 H NMR method for the diagnosis of patients with MS is more specific, highly accurate, devoid of interferences from other similar metabolites, if any, as compared to the conventional colorimetric method. The metabolic profile of upper gut aspirate provided by 1 H NMR spectroscopy demonstrates that MS patients associated with Small Intestinal Bacterial Overgrowth (SIBO) have significantly higher concentrations of unconjugated bile acids, acetate, lactate and formate as compared to MS patients without SIBO and controls. These biochemicals may damage intestinal mucosa and impair small intestinal functions in MS patients.