Protein losing enteropathy

Protein losing enteropathy refers to any condition of the gastrointestinal tract that results in a net loss of protein from the body.

Presentation
The condition may manifest itself with complications related to protein loss, including edema, or retention of fluid, and ascites, or retention of fluid in the abdomen. Proteins are absorbed in the small bowel, and any condition that affects the digestion or absorption of protein can result in protein losing enteropathy.

Causes of protein losing enteropathy include celiac disease, Crohn's disease, short bowel syndrome (where the absorptive area for proteins is decreased), intestinal lymphangiectasia, amyloidosis, enteropathy caused by NSAIDs, Ménétrier's disease, dyskeratosis congenita, IPEX and giardiasis.

Diagnosis
The diagnosis of protein losing enteropathy is typically made by excluding other causes of protein loss, such as nephrotic syndrome. Endoscopy and barium imaging can be used to localize the cause of the protein loss in the bowel. Faecal excretion of Alpha 1-antitrypsin is a marker of protein losing enteropathy.

Treatment
Treatment depends upon the underlying condition.