T2-GI Disorders: Short Bowel Syndrome

Question 1

A condition in which the body cannot absorb enough fluids and nutrients because part of the small intestine is missing (usually due to surgery or illness), or is not working properly

Answer 1

Short bowel syndrome

Question 2

What is the small intestine part of?

Answer 2

Part of digestive system, has 3 sections

Question 3

What are 3 sections of small intestine?

Answer 3

Duodenum
Jejunum
Ileum

Question 4

The shortest section located next to the stomach

Answer 4

Duodenum

Question 5

Lies between duodenum and ileum

Answer 5

Jujunum

Question 6

Largest section and connects to the large intestine (colon)

Answer 6

Ileum

Question 7

What forms a barrier between the ileum and large intestine to prevent the contents of the large intestine from flowing back into the small intestine

Answer 7

Ileocecal

Question 8

What does the small intestine do?

Answer 8

Where the absorption of fluids, proteins, carbs, iron, fat, vitamins, and minerals takes place

Question 9

If the duodenum and a portion of the jejunum have been removed by surgery, can the ilium take over their role of absorbing nutrients?

Answer 9

Yes

Question 10

If a substantial part of the jejunum or ileum is removed, is it easy or difficult to obtain adequate nutrients?

Answer 10

Difficult (in these children, nutrients usually have to be provided in a form other than food)

Question 11

Why do children need more calories than adults?

Answer 11

Children are still growing

Question 12

If a child is born with portions of the small intestine missing, can this cause serious health problems?

Answer 12

Yes

Question 13

Short bowel syndrome can occur as a ____ condition

Answer 13

Congenital condition

Question 14

The small intestine might by abnormally ___ at birth, a section of the bowel might be missing or the bowel does not form completely before birth.

Answer 14

Short

Question 15

In other cases, patients develop a condition in which a large section of the small intestine has to be removed by surgery. In newborns, especially premature babies, _____ is the most common cause of short bowel syndrome

Answer 15

Necrotizing enterocolitis

Question 16

What are some other causes of short bowel syndrome?

Answer 16

• Crohn’s disease
• Intussusception
• Blocked vessel (lack of blood flow to the intestine)
• Injury to intestine
• Cancer

Question 17

Symptoms of short bowel syndrome (7)?

Answer 17

• Bloating
• Diarrhea
• Excessive gas/foul smelling stool
• Fatigue
• Poor appetite
• Vomiting
• Weight loss or inability to gain weight

Question 18

What are some ways to treat short bowel syndrome?

Answer 18

• Change diet for necessary absorption
• TPN
• Entreral nutrition can replace TPN in some patients
• Small amounts of solid foods and liquids in addition to TPN
• Intestinal adaptation

Question 19

TPN: Do some children remain on this indefinitely or is it only short term?

Answer 19

No, some will remain on TPN indefinitely

Question 20

TPN can be life saving in children and adults unable to take appropriate nutrition through their ____.

Answer 20

GI track

Question 21

Recent changes in TPN ____ the chance of developing long-term liver injury

Answer 21

Decreases

Question 22

Overtime, can enteral nutrition replace TPN?

Answer 22

Yes, in some patients

Question 23

How are enteral feedings given?

Answer 23

G-tube

Question 24

Some children may be able to receive small amounts of solid foods and liquids in addition to enteral or parenteral feedings: How does this help babies and children?

Answer 24

Maintain the ubiquity to chew and suck and helps them develop normal eating patterns for the future

Question 25

A surgery that can help the intestine grow in size

Answer 25

Intestinal adaptation

Question 26

What types of meds are prescribed for short bowel syndrome?

Answer 26

Meds are used to help slow the passage of food through the intestine (allows more time for nutrients to remain in contact with the cells lining the intestine which improves absorption)

Question 27

When is surgery needed for short bowel syndrome?

Answer 27

When it cannot be treated with meds and diets

Question 28

If surgery occurs, can the remaining part of the intestine adapt?

Answer 28

Yes, it can adapt and assume some of the functions of the part missing, especially if the ileum is still intact

Question 29

Do children with SBS need follow up care?

Answer 29

Yes, lifelong

Question 30

What else do children with SBS need to be monitored for?

Answer 30

Closely monitored for any nutritional deficiencies

Question 31

What is the main cause of death among infants and children who receive TPN?

Answer 31

Infections and disorders of the liver and bilary tract

Question 32

Need to make sure we assess for _____

Answer 32

Line infections, picc, pac care as ordered per protocol (central lines in children can cause infectious complications)