Difference between revisions of "Short Bowel Syndrome"
(New page: {{unfinished}} {{dog}} {{cat}} ==Signalment== ==Description== Short bowel syndrome occurs when greater than two-thirds of small intestine is absent. This may be the result from sur...) |
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| − | Short bowel syndrome occurs when greater than | + | Short bowel syndrome occurs when greater than 75-90% of small intestine is absent. It is most commonly caused by iatrogenic surgical resection, although congenital anomaly can occur. The remaining small intestine cannot adequately absorb nutrients and electrolytes, resulting in diarrhoea. If the ileocolic valve has been removed, a large number of bacteria is more likely to reach the small intestine. However, this may be only be transient as the remaining of the intestine can undergo adaptive hyperplasia. This syndrome does not o |
Revision as of 08:24, 18 August 2009
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This article is still under construction. |
Description
Short bowel syndrome occurs when greater than 75-90% of small intestine is absent. It is most commonly caused by iatrogenic surgical resection, although congenital anomaly can occur. The remaining small intestine cannot adequately absorb nutrients and electrolytes, resulting in diarrhoea. If the ileocolic valve has been removed, a large number of bacteria is more likely to reach the small intestine. However, this may be only be transient as the remaining of the intestine can undergo adaptive hyperplasia. This syndrome does not o
Diagnosis
Clinical Signs
- Small intestinal diarrhoea
- Weight loss
In cases which occur after surgical bowel resection, the presenting clinical signs is sufficient to make a diagnosis. In cases of congenital origin, a plain or contrast radiography is required.
Treatment
Dietary modification
- Highly digestible, low fat diet is recommended.
- Vitamin supplementation may be required.
Antimicrobials
- A secondary antibiotic responsive diarrhoea may result if the ileocaecal valve is removed.
- Metronicazole or tylosin can be given in these cases.
Antisecretory agents & antacids
- These may be needed in cases which are poorly responsive.
- Antisecretory agents such as loperamide, diphenoxylate.
- Antacids such as ranitidine, famotidine
Nutritional support
- Total or partial parenteral nutrition may be required in some cases to provide adequate nutrition until adaptive hyperplasia takes place.
Prognosis
This is dependent on the length of the small intestine that remains. If adequate adaptive hyperplasia takes place, the patient may respond well. However, there will always be a limitation in the absoptive capacity of these animals. Some cases may respond poorly to treatment.
References
- Ettinger, S.J. and Feldman, E. C. (2000) Textbook of Veterinary Internal Medicine Diseases of the Dog and Cat Volume 2 (Fifth Edition) W.B. Saunders Company.
- Hall, E.J, Simpson, J.W. and Williams, D.A. (2005) BSAVA Manual of Canine and Feline Gastroenterology (2nd Edition) BSAVA
- Nelson, R.W. and Couto, C.G. (2009) Small Animal Internal Medicine (Fourth Edition) Mosby Elsevier.