short bowel syndrome


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short bowel syndrome

A complication of major small intestine resections (e.g., for ischaemia or inflammation), resulting in complex nutritional imbalances and/or malnutrition. In children, necrotising enterocolitis is main cause of short bowel syndrome.

Clinical findings
Excess small intestinal resection results in inadequate absorption of nutrients, minerals and vitamins, causing hypovitaminosis, malnutrition, hypochromic and megaloblastic anaemia, diarrhoea, electrolyte imbalances, and increased oxalates (derived from bile salt detergents) that pass into the circulation, which may crystallise in renal tubules causing renal failure, lactic acidosis, osteopenia and steatorrhoea. Up to 70% of the absorptive surface may be lost and tolerated. If the patient survives surgery, residual tissue undergoes adaptive hyperplasia of absorptive villi, increased absorptive cells and increased small intestinal calibre; after stabilisation and temporary parenteral nutritional support, oral feeding must be initiated as soon as possible to stimulate adaptation.

Indications for massive small intestinal resection
• Multiple congenital atresias or stenoses of the neonatal intestine; if loss is significant, diarrhoea and malabsorption appear shortly after birth; barium studies reveal a malrotated colon and markedly shortened small bowel; if infant survives first few months, intestinal function improves.
• Massive resection of gangrenous small intestine due to mesenteric arterial occlusion, traumatic interruption, volvulus or Crohn’s disease.
 
Management
Essential amino acids, low-protein diet, middle-chain triglycerides, vitamins, minerals.

short bowel syndrome

Small intestinal insufficiency Surgery A complication of major small intestine resections–eg, for ischemia or inflammation, resulting in complex nutritional imbalances and/or malnutrition; massive small intestinal resection may be required in
1. Multiple congenital atresias or stenoses of the neonatal intestine; if loss is significant, diarrhea and malabsorption appear shortly after birth; barium studies reveal a malrotated colon and markedly shortened small bowel; if infant survives first few months, intestinal function improves;.
2. Massive resection of gangrenous small intestine due to mesenteric arterial occlusion, traumatic interruption, volvulus, or Crohn's disease; in children, necrotizing enterocolitis is main cause of SBS; excess small intestinal resection results in inadequate absorption of nutrients, minerals and vitamins, causing hypovitaminosis, malnutrition, hypochromic and megaloblastic anemia, diarrhea, electrolyte imbalances, ↑ oxalates–derived from bile salt detergents that pass into the circulation, which may crystallize in renal tubules, causing renal failure, lactic acidosis, osteopenia, steatorrhea; up to 70% of the absorptive surface may be lost and tolerated; if the Pt survives surgery, residual tissue undergoes adaptive hyperplasia of absorptive villi, ↑ absorptive cells and ↑ in small intestinal caliber; after stabilization and temporary parenteral nutritional support, oral feeding must be initiated ASAP to stimulate adaption Treatment High 'quality'–ie, essential amino acids, low protein diet, middle chain TGs, vitamins, minerals. See 'Second look' operation.

short bowel syndrome

A disorder caused by the necessary surgical removal of a segment of intestine. It features weight loss, diarrhoea, fatty stools (steatorrhoea), and deficiencies of sodium, potassium and trace elements (hyponatremia, and hypokalemia). Affected people must eat several small meals a day, of readily-absorbed, finely chopped or ground foods supplemented by vitamins and minerals.

Short bowel syndrome

A condition in which the bowel is not as long as normal, either because of surgery or because of a congenital defect. Because the bowel has less surface area to absorb nutrients, it can result in malabsorption syndrome.
References in periodicals archive ?
The global short bowel syndrome diagnostics and treatment market segmentation is based on test type (complete blood test, fecal fat test, imaging tests such as X-ray, CT scan, others) and drug class (GLP-2, growth hormones, and L-glutamine, others).
The report provides a snapshot of the global therapeutic landscape of Short Bowel Syndrome
In this case series, we document 3 cases of adult intestinal toxemia botulism, which occurred in a small geographic area in a short period, and provide further evidence for the potential role of host factors, such as Crohn disease, previous bowel surgery, and short bowel syndrome, which may predispose a person to intestinal toxemia botulism.
The artificial intestines could be used to help treat patients suffering from bowel disorders including approximately 25,000 children worldwide born with a condition called short bowel syndrome who are missing a piece of intestine.
Another important next step is to determine if the intestinal tissue is effective in transplant-based treatments of intestinal diseases such as short bowel syndrome.
A surgeon diagnosed radiation-induced short bowel syndrome causing inadequate nutritional absorption.
Sixteen chapters, written by Moreno-Villares, Polanco, and 28 other pediatric specialists from Spain, Portugal, the UK, the US, and Poland, cover all the major disorders in pediatric gastroenterology--diarrhea and vomiting, coeliac disease, cow's milk allergy, inflammatory disorders, short bowel syndrome, appendicitis, gastrointestinal bleeding, liver disease, and abdominal masses--as well as less-common conditions and topics such as congenital gastrointestinal malformations, abdominal pain diagnosis, failure to thrive, and pediatric clinical dietetics.
Under this agreement, Emmaus will commercialize NutreStore, which is approved by the FDA for use in combination with human growth hormone as a treatment for short bowel syndrome (SBS).
Classification, epidemiology and aetiology of short bowel syndrome.
The company said it has shown "remarkable efficacy" in preclinical animal models of NEC and intestinal ischemia/reperfusion injury, and may have additional utility in the treatment of other intestinal disorders, such as short bowel syndrome, inflammatory bowel disease and chemotherapy-induced mucositis.
He said: ``Five or six children per million of the population have short bowel syndrome, and of those 20 to 40 per cent will develop complications that lead to liverdisease.