Abstract
106 an occur as a rare and s D -Lactic acidosis c evere complication in patients with short bowel syndrome. In healthy individuals, relatively small amounts of glucose and starch reach the colon because of extensive absorption in the small intestine. In patients with short bowel syndrome, delivery of these substrates to the colon is significantly increased. Due to an overgrowth of Gram-positive anaerobic rods, such as Lactobacillus, glucose and starch are metabolized in the colon to D-lactic acid, which is then absorbed into the systemic circulation leading to metabolic acidosis. Because D-lactate is neurotoxic (1), the clinical presentation is characterized by episodes of encephalopathy with neurological symptoms such as altered mental status, confusion, slurred speech, ataxia, hallucinations, and amnesia (2,3). D-Lactic acid is not detected in routine laboratory tests using L-lactate dehydrogenase.
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