Short Bowel Syndrome

Question 1

What is short bowel syndrome?

Answer 1

This is nutritional comprmise and malnutrition/malabsorption as a result of functional or anatomical loss of the small bowel

Question 2

What are some surgical causes of short bowel syndrome?

Answer 2

Surgical Resection

• Crohns
• Cancer
• Trauma
• Ischaemic bowel

Question 3

What are some non-surgical causes of short bowel syndrome?

Answer 3

Infection

Nectrozing enterocolitis (Premature babies)

Volvulus

Hirschprungs

IBD

Question 4

What are four effects of short bowel syndrome?

Answer 4

1. Secretory diarrhoea - ileum cant reabsorb fluid secreted by jejenum
2. Decreased fat intake and malnutrition - Steatorrhea, gall stones, osteoporosis and clotting abnormalites (no Vit K or D)
3. Colonic irritation
4. Hypergastrinaemia - Negative feedback system limiting gastrin is removed so more chance of oesophagitis, PUD

Question 5

What are 6 types of treament?

Answer 5

PPI/H2 receptor antagonists

Ocreotide - Mimics somatostatin to reduce gastric secretions

Loperimide - Reduce motility

Magnesium supplements

Hypertonic fluids

Enteral/Parental feeding - see later

Question 6

Where is magnesium absorbed?

Answer 6

ileum

Question 7

What happens in reduced magnesium absorption?

Answer 7

Low PTH (needed for it)

Hypocalcaemia

Low bone resorption

Muscle weakness, cramps, tinnitus, arrhymias, neurological symptoms