Short bowel syndrome
Short bowel syndrome | |
ICD-9 | 579.3 |
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DiseasesDB | 12026 |
MedlinePlus | 000237 |
MeSH | D012778 |
Short bowel syndrome Microchapters |
Diagnosis |
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Treatment |
Case Studies |
Short bowel syndrome On the Web |
American Roentgen Ray Society Images of Short bowel syndrome |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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
Signs and symptoms
Causes
Pathophysiology
Treatments
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 inhibitors 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 TPN - nutrition administered via intravenous line).
- Nutrition administered via gastronomy tube
Prognosis
There is no cure for short bowel syndrome. In newborn infants, the 4-year survival rate on 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.[1] 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.[2]
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.
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.
References
- ↑ Vanderhoof JA, Langnas AN (1997). "Short-bowel syndrome in children and adults". Gastroenterology. 113 (5): 1767–78. PMID 9352883.
- ↑ Gura KM, Duggan CP, Collier SB; et al. (2006). "Reversal of parenteral nutrition-associated liver disease in two infants with short bowel syndrome using parenteral fish oil: implications for future management". Pediatrics. 118 (1): e197–201. doi:10.1542/peds.2005-2662. PMID 16818533.