A 12 year old girl has history of recurrent bulky stolls and abdominal pain since 3 year of age. She has moderate pallor and her weight and height are below the 3`d percentile. Which of the following is the most appropriate investigation to make a specific diagnosis?
Answer is A (Small intestinal biopsy): 'Small intestinal mucosal biopsy is essential in the evaluation of a patient with documented steatorrhea or chronic diarrhea (>3 weeks). -- Harrisons Failure to thrive in the background of recurrent bulky stools and abdominal pain suggests a diagnosis of chronic malabsorption. Although all options provided in the question may be used to suppo the diagnosis, the most appropriate investigation to make a specific diagnosis is small intestinal biopsy.
Small intestinal biopsy
Barium studies
24-hr- fecal fat estimation
Urinary d-xylose test