Abstract
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.
Highlights
The intestine is critical for the absorption of nutrients, such as sugars, proteins, electrolytes, and water
This is the first report of de-adaptation of Short bowel syndrome (SBS) in an elderly patient due to age-related loss of bowel function
The introduction of the concept of “intestinal failure” into everyday practice as well as other organ-related conditions such as cardiac or renal failure may lead to a better understanding of the pathogenesis of malnutrition and diarrhoea in elderly patients
Summary
The intestine is critical for the absorption of nutrients, such as sugars, proteins, electrolytes, and water. Healthcare 2021, 9, x FOR PEER REVIEWThough the concept of “intestinal failure” is important when considerin3gotfh11e nutritional status of the elderly, few studies have discussed ageing and SBS or intestinal failure. Colonic specimens showed only nonspecific inflammatory findings (Figure 4a,b) We believe that this inflammatory finding was due to an imbalance. The small intestine was 5 years ago abdominal incisional hernia (strangulated ileus) excised as follows: 7 cm length from the terminal ileum and 50 cm from the ligament of Treitz. Her past history included colonic perforation, abdominal wall hernia with strangulated ileus, and resection of about 2 m 30 cm (59.1 inches) of the terminal ileum (Figure 1). Five years prior to this admission, she was diagnosed with strangulated ileus, and the small intestine was resected, 7 cm from the terminal ileum and 50 cm from the ligament of Treitz (Figure 2). Since diarrhea annudtrieelnetcst,raonlydt7ethyaeeabrrnes faoogrorme sawlitiitecshecadobdnto(otsmtirncianenuangleutidnrlaca,tieslwidovnieelaenluchosoe)unrnscial(uCTdVhienAe)dtbesnmostutuihanttllear2iitwnmtithaeo3sse0nteirxcn(mcebdiswooeefdawlsti.(hvFeeexeilgscrumicesreoadedl1ul)valsdia not absorb a CV port), which month iamftperrocvr5eeyadetaihrosenargoodfiathrrehCeVa.apSbdoho(resmtt.rwiannaagl suinlacditseiidsocnilhaeluahsre)grneiad infoglloowosd: 7gcemnleenrgathl cfroomndthietion terminal ileum and 50 cm from the about one ligament of Treitz. (Figure 2)
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