Short bowel syndrome natural history, complications and prognosis: Difference between revisions
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===Prognosis=== | ===Prognosis=== | ||
*There is no cure for short bowel syndrome. | *There is no definite cure for short bowel syndrome. However, medications | ||
*Prognosis of short bowel syndrome depends on the location and size of the bowel resection, underlying pathology, nutritional and pharmacotherapy support, and extent of intestinal adaptation.<ref name="pmid14642862">{{cite journal |vauthors=Vanderhoof JA, Young RJ |title=Enteral and parenteral nutrition in the care of patients with short-bowel syndrome |journal=Best Pract Res Clin Gastroenterol |volume=17 |issue=6 |pages=997–1015 |year=2003 |pmid=14642862 |doi= |url=}}</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="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> | *Prognosis of short bowel syndrome depends on the location and size of the bowel resection, underlying pathology, nutritional and pharmacotherapy support, and extent of intestinal adaptation.<ref name="pmid14642862">{{cite journal |vauthors=Vanderhoof JA, Young RJ |title=Enteral and parenteral nutrition in the care of patients with short-bowel syndrome |journal=Best Pract Res Clin Gastroenterol |volume=17 |issue=6 |pages=997–1015 |year=2003 |pmid=14642862 |doi= |url=}}</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="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> | ||
*The quality of life for patients with short bowel syndrome depends on their ability to previous activities. Majority of them on effective treatment could have an excellent quality of life.<ref name="pmid15233682">{{cite journal |vauthors=DiBaise JK, Young RJ, Vanderhoof JA |title=Intestinal rehabilitation and the short bowel syndrome: part 1 |journal=Am. J. Gastroenterol. |volume=99 |issue=7 |pages=1386–95 |year=2004 |pmid=15233682 |doi=10.1111/j.1572-0241.2004.30345.x |url=}}</ref> | *The quality of life for patients with short bowel syndrome depends on their ability to previous activities. Majority of them on effective treatment could have an excellent quality of life.<ref name="pmid15233682">{{cite journal |vauthors=DiBaise JK, Young RJ, Vanderhoof JA |title=Intestinal rehabilitation and the short bowel syndrome: part 1 |journal=Am. J. Gastroenterol. |volume=99 |issue=7 |pages=1386–95 |year=2004 |pmid=15233682 |doi=10.1111/j.1572-0241.2004.30345.x |url=}}</ref> | ||
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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
If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
OR
Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
OR
Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
Natural History, Complications, and Prognosis
Natural History
- The symptoms of (disease name) usually develop in the first/ second/ third decade of life, and start with symptoms such as ___.
- The symptoms of (disease name) typically develop ___ years after exposure to ___.
- If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
Complications
Common complications of short bowel syndrome may be classified to different categories, including malnutrition, surgery related, and chronic complications.[1][2][3][4][5][6][7][8][9]
- Malnutrition
- Vitamin deficiency
- Vitamin A deficiency that presents with night blindness
- Vitamin B12 deficiency that presents with megaloblastic anemia
- Vitamin C deficiency that presents with bleeding tendency
- Vitamin D deficiency that presents with osteomalacia
- Vitamin E deficiency that presents with neuropathy
- Vitamin K deficiency that presents with bleeding
- Mineral deficiency
- Iron deficiency
- Folic acid deficiency
- Calcium deficiency
- Zinc deficiency
- Magnesium deficiency
- Selenium deficiency
- Copper deficiency
- Essential fatty acid deficiency
- Vitamin deficiency
- Surgery related complications
- General complications of surgery
- Thrombosis
- Hemorrhage
- Wound infection
- Postoperative pulmonary atelectasis
- Acute kidney injury
- Pulmonary embolism
- Deep vein thrombosis
- Surgery on GI system
- Anastomotic disruption
- Anastomotic bleeding
- Catheter related complications:
- Infection of the central line
- Occlusion of the catheter due to thrombosis, fibrin formation, or precipitations
- Breakage of the central line
- Post bowel transplant complications:
- Acute rejection
- Chronic rejection
- Hepatic, portal, or mesenteric vein thrombosis
- Opportunistic infection, such as CMV, ….
- General complications of surgery
- Chronic complications
- Gastrointestinal
- Small intestinal bacterial overgrowth due to stasis
- Bowel obstruction
- Bowel motor abnormalities
- Stasis of intestinal contents
- Parenteral nutrition liver disease from steatosis to fibrosis and cirrhosis
- Bowel necrosis
- Peptic ulcers due to gastric hypersecretion
- Gallstones due to altered bile salt and bilirubin metabolism
- Hepatobiliary disease
- Lactose intolerance
- Permanent intestinal failure
- Extra-intestinal
- Kidney stone due to hyperoxaluria
- Metabolic bone disease
- Lactic acidosis
- Gastrointestinal
Prognosis
- There is no definite cure for short bowel syndrome. However, medications
- Prognosis of short bowel syndrome depends on the location and size of the bowel resection, underlying pathology, nutritional and pharmacotherapy support, and extent of intestinal adaptation.[3][7][10]
- The quality of life for patients with short bowel syndrome depends on their ability to previous activities. Majority of them on effective treatment could have an excellent quality of life.[11]
- The 6-year survival rate of patients with short bowel syndrome is approximately 65% for patients who have remaining short bowel of more than 50 cm.[10]
- 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.[12]
- Although promising, the small intestine transplant has a mixed success rate, with a postoperative mortality rate of up to 30%. One-year and 4-year survival rates are 90% and 60%, respectively.
- Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
- Depending on the extent of the [tumor/disease progression/etc.] at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor/good/excellent.
- The presence of [characteristic of disease] is associated with a particularly [good/poor] prognosis among patients with [disease/malignancy].
- [Subtype of disease/malignancy] is associated with the most favorable prognosis.
- The prognosis varies with the [characteristic] of tumor; [subtype of disease/malignancy] have the most favorable prognosis.
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.
- ↑ 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.
- ↑ 3.0 3.1 Vanderhoof JA, Young RJ (2003). "Enteral and parenteral nutrition in the care of patients with short-bowel syndrome". Best Pract Res Clin Gastroenterol. 17 (6): 997–1015. PMID 14642862.
- ↑ DiBaise JK, Young RJ, Vanderhoof JA (2004). "Intestinal rehabilitation and the short bowel syndrome: part 2". Am. J. Gastroenterol. 99 (9): 1823–32. doi:10.1111/j.1572-0241.2004.40836.x. PMID 15330926.
- ↑ 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.
- ↑ Keller J, Panter H, Layer P (2004). "Management of the short bowel syndrome after extensive small bowel resection". Best Pract Res Clin Gastroenterol. 18 (5): 977–92. doi:10.1016/j.bpg.2004.05.002. PMID 15494290.
- ↑ 7.0 7.1 Sundaram A, Koutkia P, Apovian CM (2002). "Nutritional management of short bowel syndrome in adults". J. Clin. Gastroenterol. 34 (3): 207–20. PMID 11873098.
- ↑ Tappenden KA (2014). "Pathophysiology of short bowel syndrome: considerations of resected and residual anatomy". JPEN J Parenter Enteral Nutr. 38 (1 Suppl): 14S–22S. doi:10.1177/0148607113520005. PMID 24500909.
- ↑ Limketkai BN, Parian AM, Shah ND, Colombel JF (2016). "Short Bowel Syndrome and Intestinal Failure in Crohn's Disease". Inflamm. Bowel Dis. 22 (5): 1209–18. doi:10.1097/MIB.0000000000000698. PMID 26818425.
- ↑ 10.0 10.1 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.
- ↑ DiBaise JK, Young RJ, Vanderhoof JA (2004). "Intestinal rehabilitation and the short bowel syndrome: part 1". Am. J. Gastroenterol. 99 (7): 1386–95. doi:10.1111/j.1572-0241.2004.30345.x. PMID 15233682.
- ↑ 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.