Enteric hyperoxaluria is a metabolic condition in which excessive intestinal absorption of oxalate leads to high urinary oxalate excretion. Malabsorption syndromes result in delivery of fatty acids to the colon. These bind calcium, leaving free oxalate available for absorption. Approximately 5% of patients with hyperoxaluria have an enteric cause. The most common causes of enteric hyperoxaluria are gastric bypass surgery and chronic pancreatitis; other causes include orlistat use, small-bowel resection in patients with inflammatory bowel disease, and bile acid malabsorption.

Steatorrhea and fatty acid malabsorption are common.

Individuals with enteric hyperoxaluria are at risk of developing oxalate nephropathy, a form of kidney damage caused by the deposition of calcium oxalate crystals in the renal tubules, especially if they have other risk factors, such as dehydration, low calcium intake, or pre-existing kidney disease. Oxalate nephropathy can lead to acute or chronic kidney injury, and in severe cases, end-stage renal disease.