Short bowel syndrome: Difference between revisions

	Short bowel syndrome Microchapters
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	Short bowel syndrome;
ICD-9	579.3
DiseasesDB	12026
MedlinePlus	000237
MeSH	D012778

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Latest revision as of 00:09, 30 July 2020

For patient information click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]

Synonyms and keywords: SBS; short gut syndrome; short gut; small intestine insufficiency; chronic idiopathic intestinal pseudoobstruction; hypomotility disorder; congenital short bowel syndrome; short bowel; pseudoobstructive syndrome; pseudointestinal obstructive syndrome; massive bowel resection syndrome; idiopathic intestinal pseudo-obstruction

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Short bowel syndrome from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Treatment

Case Studies

Case #1

External links

National Digestive Diseases Information Clearinghouse - Short Bowel Syndrome

Template:WikiDoc Sources

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 {{Short bowel syndrome}}
-{{CMG}}
+'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
+{{CMG}}; {{AE}} {{SSH}}
 {{SK}} SBS; short gut syndrome; short gut; small intestine insufficiency; chronic idiopathic intestinal pseudoobstruction; hypomotility disorder; congenital short bowel syndrome; short bowel; pseudoobstructive syndrome; pseudointestinal obstructive syndrome; massive bowel resection syndrome; idiopathic intestinal pseudo-obstruction
+==[[Short bowel syndrome overview|Overview]]==
-==Overview==
+==[[Short bowel syndrome historical perspective|Historical Perspective]]==
-==Signs and symptoms==
+==[[Short bowel syndrome classification|Classification]]==
-Patients with short bowel syndrome may have complications caused by malabsorption of vitamins and minerals, such as deficiencies in [[vitamin]]s [[vitamin A|A]], [[vitamin D|D]], [[vitamin E|E]], [[vitamin K|K]], and [[vitamin B12|B12]], [[calcium in biology|calcium]], [[magnesium]], [[iron]], [[folic acid]], and [[zinc]].  These may appear as [[anemia]], [[hyperkeratosis]] (scaling of the skin), easy bruising, muscle spasms, poor blood clotting, and bone pain.
+==[[Short bowel syndrome pathophysiology|Pathophysiology]]==
-==Causes==
+==[[Short bowel syndrome causes|Causes]]==
-Short bowel syndrome in adults is usually caused by surgery for:
-* [[Crohn's disease]], an inflammatory disorder of the digestive tract
-* [[Volvulus]], a spontaneous twisting of the small intestine that cuts off the blood supply and leads to tissue death
-* [[Tumor]]s of the small intestine
-* [[Injury]] or trauma to the small intestine
-* [[Necrotizing enterocolitis]] (premature newborn)
-* Bypass surgery to treat obesity, a now uncommonly performed surgical procedure
-* Surgery to remove diseases or damaged portion of the small intestine
-==Pathophysiology==
+==[[Short bowel syndrome differential diagnosis|Differentiating Short bowel syndrome from other Diseases]]==
-In healthy adults, the small intestine has an average length of approximately 6 meters (20 feet).  Short bowel syndrome usually develops when there is less than 1.8 meters (6 feet) of the small intestine left to absorb sufficient [[nutrient]]s.
-Short bowel syndrome caused by the surgical removal of a portion of the bowel may be a temporary condition, due to the adaptive property of the small intestine.
+==[[Short bowel syndrome epidemiology and demographics|Epidemiology and Demographics]]==
-In a process called intestinal adaptation, physiological changes to the remaining portion of the small intestine occur to increase its absorptive capacity.  These changes include:
+==[[Short bowel syndrome risk factors|Risk Factors]]==
-* Enlargement and lengthening of the [[villi]] found in the lining
-* Increase in the diameter of the small intestine
-* Slow down in peristalsis or movement of food through the small intestine
-==Treatments==
+==[[Short bowel syndrome screening|Screening]]==
-Symptoms of short bowel syndrome are usually addressed by prescription medicine.  These include:
-* Anti-diarrheal medicine (e.g. [[loperamide]], [[codeine]])
-* Vitamin and mineral supplements
-* [[H2 blocker]] and [[proton pump inhibitor]]s to reduce stomach acid
-* [[Lactase]] supplement (to improve the bloating and diarrhoea associated with [[lactose intolerance]])
-* Surgery, including intestinal lengthening, tapering, and [[organ transplant]].
-* Parenteral nutrition (PN or [[Total parenteral nutrition|TPN]] - nutrition administered via intravenous line).
-* Nutrition administered via gastronomy tube
-==Prognosis==
+==[[Short bowel syndrome natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
-There is no cure for short bowel syndrome.  In newborn infants, the 4-year survival rate on [[Total parenteral nutrition|parenteral nutrition]] is approximately 70%. Some studies suggest that much of the mortality is due to a complication of the TPN, especially [[chronic liver disease]].<ref>{{cite journal |author=Vanderhoof JA, Langnas AN |title=Short-bowel syndrome in children and adults |journal=Gastroenterology |volume=113 |issue=5 |pages=1767-78 |year=1997 |pmid=9352883 |doi=}}</ref> Much hope is vested in [[Omegaven]], a type of lipid TPN feed, in which recent case reports suggest the risk of liver disease is much lower.<ref>{{cite journal |author=Gura KM, Duggan CP, Collier SB, ''et al'' |title=Reversal of parenteral nutrition-associated liver disease in two infants with short bowel syndrome using parenteral fish oil: implications for future management |journal=Pediatrics |volume=118 |issue=1 |pages=e197-201 |year=2006 |pmid=16818533 |doi=10.1542/peds.2005-2662}}</ref>
-Although promising, small intestine transplant has a mixed success rate, with postoperative mortality rate of up to 30%.  One-year and 4-year survival rate are 90% and 60%, respectively.
+==Diagnosis==
+[[Short bowel syndrome history and symptoms|History and Symptoms]] | [[Short bowel syndrome physical examination|Physical Examination]] | [[Short bowel syndrome laboratory findings|Laboratory Findings]] | [[Short bowel syndrome electrocardiogram|Electrocardiogram]] | [[Short bowel syndrome x ray|X-ray]] | [[Short bowel syndrome echocardiography and ultrasound|Echocardiography and Ultrasound]] | [[Short bowel syndrome CT|CT Scan]] | [[Short bowel syndrome MRI|MRI]] | [[Short bowel syndrome other imaging findings|Other Imaging Findings]] | [[Short bowel syndrome other diagnostic studies|Other Diagnostic Studies]]
-Surgical procedures to lengthen dilated bowel include the Bianchi Procedure (where the bowel is cut in half and one end is sewn to the other) and a newer procedure called serial transverse enteroplasty (STEP -- where the bowel is cut and stapled in a zigzag pattern).  There is controversy over the efficacy of these procedures. They are usually performed by pediatric surgeons at quaternary hospital who specialize in small bowel surgery.
+==Treatment==
+[[Short bowel syndrome medical therapy|Medical Therapy]] | [[Short bowel syndrome surgery|Surgery]] | [[Short bowel syndrome primary prevention|Primary Prevention]] | [[Short bowel syndrome secondary prevention|Secondary Prevention]] | [[Short bowel syndrome cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Short bowel syndrome future or investigational therapies|Future or Investigational Therapies]] | [[Short bowel syndrome guidelines for management|Guidelines for Management]]
-==References==
+==Case Studies==
-<references/>
+[[Short bowel syndrome case study one|Case #1]]
 ==External links==
-* [http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Short_bowel_syndrome?OpenDocument Better Health Channel - Short Bowel Syndrome]
-* [http://www.healthinplainenglish.com/health/digestive/short_bowel_syndrome/index.htm Health In Plain English - Short Bowel Syndrome]
 * [http://digestive.niddk.nih.gov/ddiseases/pubs/shortbowel/ National Digestive Diseases Information Clearinghouse - Short Bowel Syndrome]
-[[Category:Malnutrition]]
-[[Category:Organ disorders]]
-[[Category:Syndromes]]
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+[[Category:Medicine]]
+[[Category:Gastroenterology]]
+[[Category:Surgery]]
+[[Category:Up-To-Date]]

Short bowel syndrome
ICD-9	579.3
DiseasesDB	12026
MedlinePlus	000237
MeSH	D012778