592
edits
Changes
no edit summary
==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. 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 necesary occur in all cases which have undergone intestinal resection.
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.
This syndrome 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 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.
==Treatment==
==Treatment==
===Nutritional support===
*Total or partial parenteral nutrition may be required in some cases to provide adequate nutrition until adaptive hyperplasia takes place.
*At the same time, it is important to continue oral feeding to stimulate mucosal hypertrophy.
===Dietary modification===
===Dietary modification===
*Small, frequent meals of highly digestible, low fat diet is recommended.
*Small, frequent meals of highly digestible, low fat diet is recommended.
===Antisecretory agents & antacids===
===Antisecretory agents & antacids===
*These may be needed in cases which are poorly responsive to lessen diarrhoea and gastric hypersecretion.
*These may be needed in cases which are poorly responsive diet and antimicrobials alone. Its aim is to lessen diarrhoea and gastric hypersecretion.
*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 that remains. 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 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.