Short bowel syndrome (Extra)

Question 1

Description

Answer 1

Patients with shorter bowels because of large surgical resection with or without stoma.

Question 2

Treatment

Answer 2

Nutritional deficiencies
May need to replace Vits & Minerals depending on extent and position of bowel resection.
- Can get Deficiencies in Vits A, B12, D, E, and K, essential fatty acids, zinc, and selenium.
- Mg for Hypomagnesaemia. Alfacalcidol may be used.

Diarrhoea and high output stomas
Diarrhoea is common
- dehydration salts
- Antimotility (loperamide, codeine, Co-phenotrope)
- Colestyramine - absorbs excess bile salts and reduce diarrhoea.
- Anti-Secretory drugs - (Omeprazole, octreotide)
- Growth factors - Teduglutide (GLP 2 agonist) - USED after stable.

Question 3

Drug absorption with short bowel

Answer 3

Higher doses may be needed or may need IV.

EC or MR unsuitable for short bowel syndrome.
Quick dissolution drugs better

SO SAME ADVICE AS STOMA.