Short bowel syndrome

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Short bowel syndrome is a condition of malabsorption (nutrients are not properly absorbed) due to extensive resection (<150cm of remaining) of small intestine or severe intestinal disease likes mesenteric ischemia, crohn disease, or necrotizing enterocolitis. The clinical presentation of patients with short bowel syndrome is dependent upon the nature and extent of intestinal resection.

What causes the Short bowel syndrome?

Short bowel syndrome is caused by:

1. Crohn’s disease
2. Volvulus
3. Necrotizing enterocolitis
4. Tumors of the small intestine
5. Intussusception
6. Injury of bowel
7. Surgical removal of small intestine

What is the Pathophysiolgy of Short bowel syndrome?

Physiologic of short-bowel syndrome is result form the loss of large amounts of intestinal absorptive surface area. The sequelae of this loss include malabsorption of electrolytes water, macronutrients like carbohydrates, fats, proteins and micronutrients include  vitamins, minerals,

What are the symptoms of Short bowel syndrome?

1. The symptoms of short bowel syndrome can include:
2. Fatigue
3. Diarrhea and steatorrhea
4. Abdominal pain
5. Fluid and electrolyte deficiency
6. Micro Nutrition (Iron, magnesium, zinc, copper and vitamins) deficiency

What are the complications of short bowel syndrome?

Complication caused by malabsorption of vitamins and minerals, complication include:

• Anemia
• Hyperkeratosis (scaling of the skin)
• Easy bruising
• Muscle spasms
• Poor blood clotting
• Bone pain

How to diagnosed short bowel syndrome?

Short bowel syndrome is diagnosed by history, clinical presentation, Blood albumin test, complete blood count and fecal fat test.

Is there a cure of Short bowel syndrome?

There is no cure of short bowel syndrome but some treatment available that can effectively reduce the symptoms and complication of the disease. Treatment includes:

• High-calorie diets
• Vitamins and mineral replacement
• Anti diarrheal medicine ( loperamide, codeine)
• H2 blocker and proton pump inhibitors to reduce stomach acid
• Parenteral nutrition

If above treatment fail to improve symptoms surgery likes intestinal transplantation or intestinal lengthening surgery may tired.

References:

• Sabiston textbook of surgery 18th edition
• Bailey and love, surgery 25th edition
• The Washington manual of surgery, 5th edition.
• emedicine.medscape.com

Filed Under: GI • Surgery

Tags: featured, SBS, Short bowel syndrome, short gut, short gut syndrome