Editing Malabsorption (section)

===Extraintestinal manifestations===
Substantial numbers of patients with intestinal malabsorption present initially with symptoms or laboratory abnormalities that point to other organ systems in the absence of or overshadowing symptoms referable to the gastrointestinal tract. For example, there is increasing epidemiologic evidence that more patients with coeliac disease present with [[anemia]] and [[osteopenia]] in the absence of significant classic gastrointestinal symptoms. Microcytic, [[macrocytic anemia|macrocytic]], or dimorphic anemia may reflect impaired [[iron]], folate, or [[vitamin B12]] absorption. [[Purpura]], [[subconjunctival hemorrhage]], or even frank bleeding may reflect hypoprothrombinemia secondary to vitamin K malabsorption. Osteopenia is common, especially in the presence of [[steatorrhea]]. Impaired calcium and vitamin D absorption and chelation of calcium by unabsorbed fatty acids resulting in fecal loss of calcium may all contribute. If calcium deficiency is prolonged, secondary hyperparathyroidism may develop. Prolonged malnutrition may induce amenorrhea, infertility, and impotence. Edema and even ascites may reflect hypoproteinemia associated with protein losing enteropathy caused by [[lymphangiectasia|lymphatic obstruction]] or extensive mucosal inflammation. Dermatitis and peripheral neuropathy may be caused by malabsorption of specific vitamins or micronutrients and essential fatty acids.<ref>{{Cite journal|last=Fine|first=KD|last2=Schiller|first2=LR|date=1999|title=technical review on the evaluation and management of chronic diarrhea|journal=Gastroenterology|volume=116|issue=6|pages=1464–1486|doi=10.1016/s0016-5085(99)70513-5|pmid=10348832|s2cid=12239612}}</ref>