Changes

==Description==

==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 in rare cases.  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.  A large resection of the small intestine may result in changes in gastrointestinal hormone re=gulation such as hypergastrinaemia and increased acid secretion.

'''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 in rare cases.  The remaining small intestine cannot adequately absorb nutrients and electrolytes, resulting in diarrhoea.  If the ileocolic valve has been removed, large number of bacteria is more likely to reach the small intestine.  Changes in gastrointestinal hormone regulation such as hypergastrinaemia and increased acid secretion may occur.

This syndrome may only be transient until the remaining of the intestine can undergo adaptive hyperplasia.  It does not necesary occur in all cases which have undergone intestinal resection.  This should ideally be avoided in the first instance.  It is may be better to perform a second surgery 24-48 hours after the first surgery in order to avoid a large resection of the small intestine.

This syndrome may only be transient until the remaining intestine can undergo adaptive hyperplasia.  However, it does not necessary occur in all cases of massive intestinal resection.  Large resection of intestine should ideally be avoided in the first instance.  If needed, it may be better to perform a second surgery 24-48 hours after the first surgery.

==Diagnosis==

==Diagnosis==

===Clinical Signs===

===Clinical Signs===

*Small intestinal diarrhoea, often with udigested food particles in the faeces

*Small intestinal diarrhoea, often with undigested food particles in the faeces

*Severe weight loss

*Severe 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.  

In cases which occur after surgical bowel resection, the presenting clinical signs are sufficient to make a diagnosis.  In cases of congenital origin, a plain or contrast radiography is required.  

==Treatment==

==Treatment==

===Nutritional support===

===Nutritional support===

*Total or partial parenteral nutrition may be required in some cases to provide adequate nutrition until adaptive hyperplasia takes place.

*Total or partial parenteral nutrition may be required to provide adequate nutrition until adaptive hyperplasia takes place.

*At the same time, it is important to continue oral feeding to stimulate mucosal hypertrophy.

*At the same time, it is important to continue oral feeding to stimulate mucosal hypertrophy.

*Antisecretory agents such as loperamide, diphenoxylate.

*Antisecretory agents such as loperamide, diphenoxylate.

*Antacids such as ranitidine, famotidine.

*Antacids such as ranitidine, famotidine.

==Prognosis==

==Prognosis==

This is dependent on the length of the small intestine left and response to therapy.  If adequate adaption occurs, the patient may respond well and eventually be ablet to consume near-normal diet.  However, there will always be a limitation in the absoptive capacity of these animals.  Some cases may respond poorly and can never be fed on a normal diet or some may die.  Malnourished animals have a poorer prognosis.

This is dependent on the length of the small intestine left and response to therapy.  If adequate adaption occurs, the patient may respond well and eventually be able to consume a near-normal diet.  However, there will always be a limitation in the absorptive capacity of these animals.  Some cases may respond poorly and can never be fed on a normal diet and others may die.  Malnourished animals have a poorer prognosis.