Etiological spectrum of non-celiac malabsorption in pediatric population in a tertiary care hospital.

Abstract

Objective: To determine the etiological spectrum of non-celiac malabsorption in pediatric population at a tertiary care hospital. Study Design: Analytical, cross-sectional study. Setting: Department of Gastroenterology, National Institute of Child Health (NICH), Karachi, Pakistan. Period: July 2025 to November 2025. Methods: Children aged 2–10 years presenting with symptoms of malabsorption for more than two weeks were enrolled through consecutive sampling. Stool analysis were performed to confirm etiology. Data were analyzed using SPSS version 26.0. Results: In a total of 220 children, 124 (56.4%) were males, and median age of 6.0 years (IQR 4.0–8.0). Chronic diarrhea 194 (88.2%) and steatorrhea 107 (48.6%) were the most common clinical manifestations. Giardiasis was the most frequent etiology 72 (32.7%), followed by carbohydrate malabsorption 54 (24.5%), fat malabsorption 41 (18.6%), protein malabsorption 27 (12.3%), and chronic intestinal infection 26 (11.8%). Age (p=0.041), residence (p=0.021), parental education (p=0.029), and hemoglobin levels (p=0.004) showed significant associations with etiology of non-celiac malabsorption. Chronic diarrhea was most frequent in Giardiasis (95.8%) and chronic intestinal infection (96.2%) with a significant association (p=0.032). Steatorrhea was strongly linked to fat malabsorption (87.8%, p<0.001). Fatigue or pallor was more common in infective etiologies, seen in Giardiasis (45.8%) and chronic intestinal infection (42.3%) (p=0.018). Conclusion: Infectious causes, particularly Giardiasis, remain the leading etiology of non-celiac malabsorption among children. Infective etiologies were associated with anemia, chronic diarrhea, and nutritional compromise, whereas non-infective causes were linked with specific nutrient malabsorption profiles.