Short Bowel Syndrome

Question 1

what nutritional deficiences do people with short bowel have and therefore need replacing?

Answer 1

vitamin A, B12, D, E, and K, essential fatty acids, zinc, selenium

Question 2

what drugs can be used to manage high output stomas?

Answer 2

loperamide, codeine to reduce motility

Question 3

what electrolyte disturbance is seen with short bowel syndrome?

Answer 3

hypomagnesium

Question 4

alongside loperamide and codeine, what other anti motility drug has been used to manage high output stomas and why is its use limited?

Answer 4

co-phenotrope
crosses BBB which may limit use, also has potential for dependence and anticholinergic effects

Question 5

what is colestyramine used for in short bowel?

Answer 5

binds to unabsorbed bile salts and reduces diarrhoea

Question 6

what antisecretory drugs can be used in short bowel and whats their purpose?

Answer 6

omeprazole - reduces gastric acid
octreotide - reduces ileostomy diarrhoea and large volume jejunostomsy output