scholarly journals Consideration of Intestinal Failure in Cases of De-Adaptation of Short Bowel Syndrome: A Case Report and Descriptive Review

Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1660
Author(s):  
Tasuku Kato ◽  
Yasuhisa Nakano ◽  
Fumiko Yamane ◽  
Ryuichi Ohta ◽  
Chiaki Sano
Keyword(s):  
Short Bowel Syndrome ◽  
Case Reports ◽  
Intestinal Failure ◽  
Intestinal Resection ◽  
Electrolyte Imbalance ◽  
Routine Practice ◽  
Intestinal Function ◽  
Short Bowel ◽  
First Time ◽  
The Relationship

Short bowel syndrome (SBS) causes malabsorption due to extensive intestinal resection. While intestinal function declines with age, little is known about the relationship between intestinal failure and ageing. For the first time in Japan, we report a case of de-adaptation of SBS thought to be due to ageing, in a 93-year-old woman who presented with electrolyte imbalance and malnutrition. She had undergone five surgical resections of the small intestine over the past 20 years. She had developed SBS once due to multiple surgeries, but due to compensatory function, the symptoms had abated. However, due to decreased intestinal function caused by ageing, it worsened and symptoms reappeared. A literature search for the period January 1990 to May 2021 in Ichushi a major journal in Japan, found that de-adaptation of SBS occurred in 23 previous cases, of which we were able to confirm the details in 17 cases, with no case reports on “de-adaptation of SBS”, demonstrating that the concept of “intestinal failure” has only recently begun to be used in routine practice. Therefore, we stress the importance of re-emphasizing the concept of ”intestinal failure” in everyday practice, as well as other organ-related conditions such as cardiac or renal failure, as this may lead to a better understanding of the pathogenesis of malnutrition and diarrhoea in elderly patients.

Short Bowel Syndrome

2015 ◽  
Author(s):  
Robert Burakoff ◽  
Alison Goldin
Keyword(s):  
Small Intestine ◽  
Short Bowel Syndrome ◽  
Average Length ◽  
Intestinal Failure ◽  
Clinical Manifestations ◽  
Intestinal Resection ◽  
Intestinal Atresia ◽  
Congenital Defects ◽  
Short Bowel ◽  
Vascular Insufficiency

Short bowel syndrome (SBS) is a state of malabsorption resulting from physical or functional loss of large portions of the small intestine, and is the most common cause of intestinal failure. The average length of a human’s small intestine is between 3 and 8 m, depending on the type of measurements made (surgical, radiologic, or autopsy); SBS occurs when less than 200 cm of small bowel remains. SBS may be congenital (intestinal atresia) or acquired. Physical losses usually occur from surgical resection for Crohn disease (CD), vascular insufficiency, radiation, malignancy, trauma, or volvulus. The site of intestinal resection helps to determine the degree of intestinal capacity. Functional losses, on the other hand, are less common and occur in the setting of a nonfunctioning, but intact, small intestine. Examples include radiation enteritis, congenital defects, and inflammatory bowel disease (IBD). This review addresses the epidemiology, pathophysiology and pathogenesis, clinical manifestations, treatment, complications, and prognosis of SBS. A figure shows sites of intestinal nutrient absorption. A table lists potential complications of SBS in patients receiving parenteral nutrition (PN). This review contains 1 highly rendered figure, 1 table, and 67 references. 

scholarly journals Biodistribution of the radiophamarceutical sodium pertechnetate (Na99mTcO4) after massive small bowel resection in rats

2007 ◽  
Vol 22 (6) ◽  
pp. 430-435 ◽  
Author(s):  
Dâmaso de Araújo Chacon ◽  
Irami Araújo-Filho ◽  
Arthur Villarim-Neto ◽  
Amália Cínthia Meneses Rêgo ◽  
Ítalo Medeiros Azevedo ◽  
...  
Keyword(s):  
Small Intestine ◽  
Short Bowel Syndrome ◽  
Intestinal Mucosa ◽  
Intestinal Resection ◽  
Small Bowel Resection ◽  
Control Group ◽  
Short Bowel ◽  
Massive Resection ◽  
Mucosal Thickness ◽  
Misleading Interpretation

PURPOSE: To evaluate the biodistribution of sodium pertecnetate (Na99mTcO4) in organs and tissues, the morphometry of remnant intestinal mucosa and ponderal evolution in rats subjected to massive resection of the small intestine. METHODS: Twenty-one Wistar rats were randomly divided into three groups of 7 animals each. The short bowel (SB) group was subjected to massive resection of the small intestine; the control group (C) rats were not operated on, and soft intestinal handling was performed in sham rats. The animals were weighed weekly. On the 30th postoperative day, 0.l mL of Na99mTcO4, with mean activity of 0.66 MBq was injected intravenously into the orbital plexus. After 30 minutes, the rats were killed with an overdose of anesthetic, and fragments of the liver, spleen, pancreas, stomach, duodenum, small intestine, thyroid, lung, heart, kidney, bladder, muscle, femur and brain were harvested. The biopsies were washed with 0.9% NaCl.,The radioactivity was counted using Gama Counter WizardTM 1470, PerkinElmer. The percentage of radioactivity per gram of tissue (%ATI/g) was calculated. Biopsies of the remaining jejunum were analysed by HE staining to obtain mucosal thickness. Analysis of variance (ANOVA) and the Tukey test for multiple comparisons were used, considering p<0.05 as significant. RESULTS: There were no significant differences in %ATI/g of the Na99mTcO4 in the organs of the groups studied (p>0.05). An increase in the weight of the SB rats was observed after the second postoperative week. The jejunal mucosal thickness of the SB rats was significantly greater than that of C and sham rats (p<0.05). CONCLUSION: In rats with experimentally-produced short bowel syndrome, an adaptive response by the intestinal mucosa reduced weight loss. The biodistribution of Na99mTcO4 was not affected by massive intestinal resection, suggesting that short bowel syndrome is not the cause of misleading interpretation, if an examination using this radiopharmaceutical is indicated.

scholarly journals Energy absorption as a measure of intestinal failure in the short bowel syndrome.

Gut ◽  
1989 ◽  
Vol 30 (2) ◽  
pp. 176-183 ◽  
Author(s):  
C A Rodrigues ◽  
J E Lennard-Jones ◽  
D G Thompson ◽  
M J Farthing
Keyword(s):  
Energy Absorption ◽  
Short Bowel Syndrome ◽  
Intestinal Failure ◽  
Short Bowel

Intestinal Failure and Short Bowel Syndrome

Medicine ◽  
2003 ◽  
Vol 31 (3) ◽  
pp. 98-100 ◽  
Author(s):  
Alastair Forbes
Keyword(s):  
Short Bowel Syndrome ◽  
Intestinal Failure ◽  
Short Bowel

Fecal Microbiome and Bile Acid Metabolome in Adult Short Bowel Syndrome

2021 ◽  
Author(s):  
Harold J. Boutte ◽  
Jacqueline Chen ◽  
Todd N. Wylie ◽  
Kristine M. Wylie ◽  
Yan Xie ◽  
...  
Keyword(s):  
Bile Acid ◽  
Gut Microbiota ◽  
Short Bowel Syndrome ◽  
Lithocholic Acid ◽  
Intestinal Failure ◽  
Patient Specific ◽  
Rrna Gene ◽  
Healthy Controls ◽  
Fecal Microbiome ◽  
Short Bowel

Background & Aims: Loss of functional small bowel surface area causes short bowel syndrome (SBS), intestinal failure, and parenteral nutrition (PN) dependence. The gut adaptive response following resection may be difficult to predict, and it may take up to two years to determine which patients will wean from PN. Here we examined features of gut microbiota and bile acid (BA) metabolism in determining adaptation and ability to wean from PN. Methods: Stool and sera were collected from healthy controls and from SBS patients (n=52) with ileostomy, jejunostomy, ileocolonic and jejunocolonic anastomoses fed with PN plus enteral nutrition or who were exclusively enterally fed. We undertook 16S rRNA gene sequencing, BA profiling and 7α-hydroxy-4-cholesten-3-one (C4) quantitation with LC-MS/MS, and serum amino acid analyses. Results: SBS patients exhibited altered gut microbiota with reduced gut microbial diversity compared to healthy controls. We observed differences in the microbiomes of SBS patients with ileostomy vs. jejunostomy, jejunocolonic vs. ileocolonic anastomoses, and PN-dependence compared to those who weaned from PN. Stool and serum BA composition and C4 concentrations were also altered in SBS patients, reflecting adaptive changes in enterohepatic BA cycling. Stools from patients who weaned from PN were enriched in secondary BAs including deoxycholic acid and lithocholic acid. Conclusions: Shifts in gut microbiota and BA metabolites may generate a favorable luminal environment in select SBS patients, promoting the ability to wean from PN. Pro-adaptive microbial species and select BA may provide novel targets for patient-specific therapies for SBS.

scholarly journals Measurement of Utilities Associated with Parenteral Support Requirement in Patients with Short Bowel Syndrome and Intestinal Failure

2018 ◽  
Vol 40 (11) ◽  
pp. 1878-1893.e1 ◽  
Author(s):  
Rachel Ballinger ◽  
Jake Macey ◽  
Andrew Lloyd ◽  
John Brazier ◽  
Joanne Ablett ◽  
...  
Keyword(s):  
Short Bowel Syndrome ◽  
Intestinal Failure ◽  
Short Bowel ◽  
Parenteral Support
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