Short bowel syndrome laboratory findings: Difference between revisions
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==Overview== | ==Overview== | ||
Laboratory findings consistent with the diagnosis of short bowel syndrome include anemia, hypoalbuminemia, low level of vitamins, | Laboratory findings consistent with the [[diagnosis]] of short bowel syndrome include [[anemia]], [[hypoalbuminemia]], low level of [[Vitamin|vitamins]], [[Mineral|minerals]], and [[Dietary mineral|micronutrients]]. Level of [[Acute phase protein|acute phase reactants]] is high. Abnormal [[liver function tests]] including elevated [[Liver function tests|liver enzymes]] and [[bilirubin]] might be seen. [[Fluid]] and [[Electrolyte disturbance|electrolyte imbalance]] might be present. [[Fecal fat]] test is usually positive. | ||
==Laboratory Findings== | ==Laboratory Findings== | ||
Laboratory findings consistent with the [[diagnosis]] of short bowel syndrome include:<ref name="Wall2013">{{cite journal|last1=Wall|first1=Elizabeth A.|title=An Overview of Short Bowel Syndrome Management: Adherence, Adaptation, and Practical Recommendations|journal=Journal of the Academy of Nutrition and Dietetics|volume=113|issue=9|year=2013|pages=1200–1208|issn=22122672|doi=10.1016/j.jand.2013.05.001}}</ref><ref name="BoteyAlastrué2017">{{cite journal|last1=Botey|first1=Mireia|last2=Alastrué|first2=Antonio|last3=Haetta|first3=Henrik|last4=Fernández-Llamazares|first4=Jaume|last5=Clavell|first5=Arantxa|last6=Moreno|first6=Pau|title=Long-Term Results of Serial Transverse Enteroplasty with Neovalve Creation for Extreme Short Bowel Syndrome: Report of Two Cases|journal=Case Reports in Gastroenterology|volume=11|issue=1|year=2017|pages=229–240|issn=1662-0631|doi=10.1159/000452734}}</ref><ref name="ThompsonWeseman2011">{{cite journal|last1=Thompson|first1=Jon S.|last2=Weseman|first2=Rebecca|last3=Rochling|first3=Fedja A.|last4=Mercer|first4=David F.|title=Current Management of the Short Bowel Syndrome|journal=Surgical Clinics of North America|volume=91|issue=3|year=2011|pages=493–510|issn=00396109|doi=10.1016/j.suc.2011.02.006}}</ref><ref name="pmid11873098">{{cite journal |vauthors=Sundaram A, Koutkia P, Apovian CM |title=Nutritional management of short bowel syndrome in adults |journal=J. Clin. Gastroenterol. |volume=34 |issue=3 |pages=207–20 |year=2002 |pmid=11873098 |doi= |url=}}</ref><ref name="BechtoldMcClave2014">{{cite journal|last1=Bechtold|first1=Matthew L.|last2=McClave|first2=Stephen A.|last3=Palmer|first3=Lena B.|last4=Nguyen|first4=Douglas L.|last5=Urben|first5=Lindsay M.|last6=Martindale|first6=Robert G.|last7=Hurt|first7=Ryan T.|title=The Pharmacologic Treatment of Short Bowel Syndrome: New Tricks and Novel Agents|journal=Current Gastroenterology Reports|volume=16|issue=7|year=2014|issn=1522-8037|doi=10.1007/s11894-014-0392-2}}</ref><ref name="DiBaiseYoung2004">{{cite journal|last1=DiBaise|first1=John K.|last2=Young|first2=Rosemary J.|last3=Vanderhoof|first3=Jon A.|title=Intestinal Rehabilitation and the Short Bowel Syndrome: Part 1|journal=The American Journal of Gastroenterology|volume=99|issue=7|year=2004|pages=1386–1395|issn=0002-9270|doi=10.1111/j.1572-0241.2004.30345.x}}</ref><ref name="DiBaiseYoung2004">{{cite journal|last1=DiBaise|first1=John K.|last2=Young|first2=Rosemary J.|last3=Vanderhoof|first3=Jon A.|title=Intestinal Rehabilitation and the Short Bowel Syndrome: Part 2|journal=The American Journal of Gastroenterology|volume=99|issue=9|year=2004|pages=1823–1832|issn=0002-9270|doi=10.1111/j.1572-0241.2004.40836.x}}</ref><ref name="KellerPanter2004">{{cite journal|last1=Keller|first1=Jutta|last2=Panter|first2=Heidi|last3=Layer|first3=Peter|title=Management of the short bowel syndrome after extensive small bowel resection|journal=Best Practice & Research Clinical Gastroenterology|volume=18|issue=5|year=2004|pages=977–992|issn=15216918|doi=10.1016/S1521-6918(04)00060-5}}</ref><ref name="Tappenden2014">{{cite journal|last1=Tappenden|first1=Kelly A.|title=Pathophysiology of Short Bowel Syndrome|journal=Journal of Parenteral and Enteral Nutrition|volume=38|issue=1_suppl|year=2014|pages=14S–22S|issn=0148-6071|doi=10.1177/0148607113520005}}</ref><ref name="EçaBarbosa2016">{{cite journal|last1=Eça|first1=Rosário|last2=Barbosa|first2=Elisabete|title=Short bowel syndrome: treatment options|journal=Journal of Coloproctology|volume=36|issue=4|year=2016|pages=262–272|issn=22379363|doi=10.1016/j.jcol.2016.07.002}}</ref><ref name="RodriguesSeetharam2011">{{cite journal|last1=Rodrigues|first1=Gabriel|last2=Seetharam|first2=Prasad|title=Short bowel syndrome: A review of management options|journal=Saudi Journal of Gastroenterology|volume=17|issue=4|year=2011|pages=229|issn=1319-3767|doi=10.4103/1319-3767.82573}}</ref> | |||
* | *'''[[Complete blood count]] (CBC):''' | ||
**[[Anemia]] either [[Microcytic anemia|microcytic]] or [[Macrocytic anemia|macrocytic]] | |||
* | *'''Low levels of [[albumin]]''' | ||
* | *'''High levels of [[Acute phase protein|acute phase reactant]]''' | ||
**High [[C-reactive protein]] ([[C-reactive protein|CRP]]) (normal- 0 to 10 mg/dl) | |||
**High [[erythrocyte sedimentation rate]] ([[Erythrocyte sedimentation rate|ESR]]) (normal for women is < 20 mm/hour and for men is <15 mm/hour) | |||
*[[Liver function tests|'''Liver function test''']] | |||
**High [[Aspartate transaminase|aspartate aminotransferase]] ([[Aspartate transaminase|AST]]) (normal- 8 to 48 U/L) | |||
**High [[Alanine transaminase|alanine aminotransferase]] ([[Alanine transaminase|ALT]]) (normal- 7 to 55 units per liter U/L) | |||
**High [[Bilirubin|serum bilirubin]] (normal - 0.1 to 1.2 mg/dl) | |||
* | *'''Blood chemistry profile''' | ||
**[[ | **High [[blood urea nitrogen]] ([[Blood urea nitrogen|BUN]]) (normal- 7 to 20 mg/dl) | ||
**[[Vitamin]] levels | **High serum [[creatinine]] (normal- 0.8 to 1.2 md/dl) | ||
**[[Hyponatremia|Low sodium]] (normal- 135/145 mEq/L) | |||
**[[Hypokalemia|Low potassium]] (normal- 3.5 to 5.5 mEq/L) | |||
**Low [[chloride]] (normal- 97 to 107 mEq/L) | |||
*'''[[Vitamin]] and [[mineral]] levels:''' | |||
**Low levels of [[vitamin A]] | |||
**Low levels of [[vitamin B12]] | |||
**Low levels of [[vitamin C]] | |||
**Low level of [[vitamin D]] | |||
**Low level of [[Tocopherol|vitamin E]] | |||
**Low level of [[vitamin K]] | |||
**Low [[iron]] | |||
**Low [[Folic Acid|folic acid]] | |||
**[[Hypocalcemia|Low calcium]] | |||
**[[Hypomagnesemia|Low magnesium]] | |||
**Low [[phosphorus]] | |||
**Low [[zinc]] | |||
**Low [[chromium]] | |||
**Low [[selenium]] | |||
*'''High [[fecal fat]]''' | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
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[[Category:Medicine]] | |||
[[Category:Gastroenterology]] | |||
[[Category:Surgery]] | |||
[[Category:Up-To-Date]] | |||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]
Overview
Laboratory findings consistent with the diagnosis of short bowel syndrome include anemia, hypoalbuminemia, low level of vitamins, minerals, and micronutrients. Level of acute phase reactants is high. Abnormal liver function tests including elevated liver enzymes and bilirubin might be seen. Fluid and electrolyte imbalance might be present. Fecal fat test is usually positive.
Laboratory Findings
Laboratory findings consistent with the diagnosis of short bowel syndrome include:[1][2][3][4][5][6][6][7][8][9][10]
- Complete blood count (CBC):
- Anemia either microcytic or macrocytic
- Low levels of albumin
- High levels of acute phase reactant
- High C-reactive protein (CRP) (normal- 0 to 10 mg/dl)
- High erythrocyte sedimentation rate (ESR) (normal for women is < 20 mm/hour and for men is <15 mm/hour)
- Liver function test
- High aspartate aminotransferase (AST) (normal- 8 to 48 U/L)
- High alanine aminotransferase (ALT) (normal- 7 to 55 units per liter U/L)
- High serum bilirubin (normal - 0.1 to 1.2 mg/dl)
- Blood chemistry profile
- High blood urea nitrogen (BUN) (normal- 7 to 20 mg/dl)
- High serum creatinine (normal- 0.8 to 1.2 md/dl)
- Low sodium (normal- 135/145 mEq/L)
- Low potassium (normal- 3.5 to 5.5 mEq/L)
- Low chloride (normal- 97 to 107 mEq/L)
- Vitamin and mineral levels:
- Low levels of vitamin A
- Low levels of vitamin B12
- Low levels of vitamin C
- Low level of vitamin D
- Low level of vitamin E
- Low level of vitamin K
- Low iron
- Low folic acid
- Low calcium
- Low magnesium
- Low phosphorus
- Low zinc
- Low chromium
- Low selenium
- High fecal fat
References
- ↑ Wall, Elizabeth A. (2013). "An Overview of Short Bowel Syndrome Management: Adherence, Adaptation, and Practical Recommendations". Journal of the Academy of Nutrition and Dietetics. 113 (9): 1200–1208. doi:10.1016/j.jand.2013.05.001. ISSN 2212-2672.
- ↑ Botey, Mireia; Alastrué, Antonio; Haetta, Henrik; Fernández-Llamazares, Jaume; Clavell, Arantxa; Moreno, Pau (2017). "Long-Term Results of Serial Transverse Enteroplasty with Neovalve Creation for Extreme Short Bowel Syndrome: Report of Two Cases". Case Reports in Gastroenterology. 11 (1): 229–240. doi:10.1159/000452734. ISSN 1662-0631.
- ↑ Thompson, Jon S.; Weseman, Rebecca; Rochling, Fedja A.; Mercer, David F. (2011). "Current Management of the Short Bowel Syndrome". Surgical Clinics of North America. 91 (3): 493–510. doi:10.1016/j.suc.2011.02.006. ISSN 0039-6109.
- ↑ Sundaram A, Koutkia P, Apovian CM (2002). "Nutritional management of short bowel syndrome in adults". J. Clin. Gastroenterol. 34 (3): 207–20. PMID 11873098.
- ↑ Bechtold, Matthew L.; McClave, Stephen A.; Palmer, Lena B.; Nguyen, Douglas L.; Urben, Lindsay M.; Martindale, Robert G.; Hurt, Ryan T. (2014). "The Pharmacologic Treatment of Short Bowel Syndrome: New Tricks and Novel Agents". Current Gastroenterology Reports. 16 (7). doi:10.1007/s11894-014-0392-2. ISSN 1522-8037.
- ↑ 6.0 6.1 DiBaise, John K.; Young, Rosemary J.; Vanderhoof, Jon A. (2004). "Intestinal Rehabilitation and the Short Bowel Syndrome: Part 1". The American Journal of Gastroenterology. 99 (7): 1386–1395. doi:10.1111/j.1572-0241.2004.30345.x. ISSN 0002-9270.
- ↑ Keller, Jutta; Panter, Heidi; Layer, Peter (2004). "Management of the short bowel syndrome after extensive small bowel resection". Best Practice & Research Clinical Gastroenterology. 18 (5): 977–992. doi:10.1016/S1521-6918(04)00060-5. ISSN 1521-6918.
- ↑ Tappenden, Kelly A. (2014). "Pathophysiology of Short Bowel Syndrome". Journal of Parenteral and Enteral Nutrition. 38 (1_suppl): 14S–22S. doi:10.1177/0148607113520005. ISSN 0148-6071.
- ↑ Eça, Rosário; Barbosa, Elisabete (2016). "Short bowel syndrome: treatment options". Journal of Coloproctology. 36 (4): 262–272. doi:10.1016/j.jcol.2016.07.002. ISSN 2237-9363.
- ↑ Rodrigues, Gabriel; Seetharam, Prasad (2011). "Short bowel syndrome: A review of management options". Saudi Journal of Gastroenterology. 17 (4): 229. doi:10.4103/1319-3767.82573. ISSN 1319-3767.