History Of Short Bowel Syndrome Research Articles

Improvement in metabolic indices including thyroid hormones via enhanced absorption of nutrients by Teduglutide in short bowel syndrome.

Introduction and importanceShort bowel syndrome is characterized by maldigestion and malabsorption resulting in deficiencies of multiple nutrients including vitamins and minerals. Most subjects required parental elimination for survival. GLP-2 RA Teduglutide was recently approved for treatment of short bowel syndrome especially for those requiring parenteral support. Our intent in reporting this subject is to demonstrate the utility of Teduglutide in improving multiple metabolic indices in presence of short bowel syndrome.Case presentation and clinical discussion66-year-old Caucasian female presented with a history of short bowel syndrome and associated vitamin deficiencies, hypothyroidism requiring large dose (300 μg) of levothyroxine, diarrhea and liver cirrhosis. Upon starting teduglutide the subject saw improvement in her symptoms. Moreover, daily dose of Levothyroxine required a gradual decrease to maintain desirable serum concentrations of Free T4, Free T3 and TSH. Serum levels of several vitamins attained greater than therapeutic concentrations requiring dosage reductions. Also notable was the improvement in her liver function tests, remission from ascites and episodes of hepatic encephalopathy and regeneration of liver nodules.ConclusionFollowing administration of GLP2 therapy, an adult subject with short bowel syndrome with concurrent hypothyroidism and multiple vitamin deficiencies, demonstrated a marked improvement in her metabolic parameters resulting in reduction in daily medication doses along with improvement in manifestations of liver cirrhosis.

Отдаленные последствия синдрома короткой кишки у ребенка 13 лет

Objective of the Paper: to demonstrate the observation of the long-term consequences of postresection short bowel syndrome in a 13-year- old boy. Key Рoints. Short bowel syndrome (SBS) is characterized by a low absorption capacity of the small intestine as a result of extensive resections, which is manifested by malabsorption, malnutrition and digestive disorders. Observation of a 13-year-old child with a history of postresection short bowel syndrome 10 years after acquiring intestinal autonomy (independence from parenteral nutrition) illustrates the long-term consequences SBS: megaloblastic B12-deficient anemia with neurological symptoms, delayed physical development, persistent anastomositis. Conclusion. In children with a history of short bowel syndrome, after acquiring intestinal autonomy, some risks remain that significantly disrupt the patient's health. Such patients need long-term food insurance and supervision by a multidisciplinary team of specialists. Keywords: short bowl syndrome, small intestine resection, malabsorption, parenteral nutrition, chronic intestinal failure, intestinal autonomy, B12-deficient anemia.

SAT-LB86 Improvement In Metabolic Indices Including Thyroid HormonesVia Enhanced Absorption Of Nutrients By Teduglutide In Short Bowel Syndrome

Background: Short bowel syndrome is characterized by maldigestion and malabsrption resulting in deficiencies of multiple nutrients including vitamins and minerals. Most subjects required parental elimination for survival. GLP 2 RA Teduglutide was recently approved for treatment of short-bowel syndrome especially for those requiring parenteral support. Objective: To demonstrate the utility of GLP2 Receptor Agonist Teduglutide in improvising multiple metabolic indices In presence of short bowel syndrome. Case presentation: 66-year-old Caucasian female presented with a history of short bowel syndrome and associated vitamin deficiencies, hypothyroidism requiring large dose of levothyroxine, diarrhea, and liver cirrhosis. Upon starting teduglutide the subject saw improvement in her symptoms. Moreover, daily dose of levothyroxine required reductions from 300 mcg to 150 mcg to maintain desirable serum concentrations of free T4, free T3 and TSH. Finally, serum levels of several vitamins attained greater than therapeutic concentrations requiring dosage reductions. Also notable was the improvement in her liver function tests, remission from ascites and regeneration of liver nodules. Conclusion: Herein, we report an adult subject with short bowel syndrome with concurrent hypothyroidism and multiple vitamin deficiencies who following administration of GLP2 RA therapy demonstrated a marked improvement in her metabolic parameters with some requiring reduction in daily dose along with improvement in manifestations of liver cirrhosis.

Septic pulmonary emboli caused by infected central venous port

A 54-year-old Japanese woman receiving home parenteral nutrition through a subcutaneously implanted central venous (CV) port presented with fever, chills, nonproductive cough and right-sided chest pain. She had a history...

D-lactic acidosis: an underrecognized complication of short bowel syndrome.

D-lactic acidosis or D-lactate encephalopathy is a rare condition that occurs primarily in individuals who have a history of short bowel syndrome. The unabsorbed carbohydrates act as a substrate for colonic bacteria to form D-lactic acid among other organic acids. The acidic pH generated as a result of D-lactate production further propagates production of D-lactic acid, hence giving rise to a vicious cycle. D-lactic acid accumulation in the blood can cause neurologic symptoms such as delirium, ataxia, and slurred speech. Diagnosis is made by a combination of clinical and laboratory data including special assays for D-lactate. Treatment includes correcting the acidosis and decreasing substrate for D-lactate such as carbohydrates in meals. In addition, antibiotics can be used to clear colonic flora. Although newer techniques for diagnosis and treatment are being developed, clinical diagnosis still holds paramount importance, as there can be many confounders in the diagnosis as will be discussed subsequently.

Serotonin syndrome and acute hyponatremia, complex overlapping syndromes, a case report and review

Objective: To report the first case of simultaneous serotonin syndrome and acute hyponatremia secondary to sertraline and drug interactions resulting in patients’ death (Naranjo ADR probability score 7). Case Summary: An 83-year-old female on sertraline for 5 years for depression was admitted for left tibial plateau fracture. She had a history of short bowel syndrome, total parenteral nutrition and CKD stage 3 secondary to vascular disease. 2 weeks post operatively, she developed into difficulty concentrating, tachycardia, hyperreflexia and clonus in context of opioids and antiemetic use but was afebrile and haemodynamically stable. She also developed into acute hyponatremia from 133 mmol/L to 127 mmol/L within 24 hours. Sertraline and antiemetic medications were stopped and cyproheptadine and diazepam were started to treat serotonin syndrome. The patient deteriorated after an initial improvement. She developed into aspiration pneumonia later and passed away in ICU. Discussion: Both acute hyponatremia and serotonin syndrome share SSRIs as common etiology, which have acute onset and rapid resolution and show multiple overlapping neurological features. Hunter criteria are more accurate than Sternbach criteria due to less emphasis on mental features to diagnose serotonin syndrome with overlapping conditions with similar presentation. Hyponatremia causes muscle weakness with hyporeflexia compared to serotonin syndrome with hyperreflexia and clonus. Conclusion: Clinicians should be aware of possibility of both acute hyponatremia and serotonin syndrome secondary to SSRIs interacting with opioids and ondansetron. The use of Hunter criteria would aid in prompting diagnosis and initiation of timely treatment.

Impact of infantile short bowel syndrome on long-term health-related quality of life: a cross-sectional study

Background/PurposeStudies on the long-term effects of short bowel syndrome (SBS) on the quality of life are scarce. Therefore, we determined health-related quality of life (HRQoL) in children and adolescents with a history of infantile SBS compared with that of same-aged controls drawn from the general population. MethodsCross-sectional assessment (2005-2007) of HRQoL in children with a history of infantile SBS treated in their first year of life, born between 1987 and 2002, using generic HRQoL measures was performed. Children aged 5 to 18 years and their parents filled out the Pediatric Quality of Life Inventory. Differences in scores between subjects and controls were analyzed using independent sample t tests. ResultsThirty-one children with a history of SBS (19 girls and 12 boys; mean age, 11.8 ± 4.2 years) participated, giving an overall response rate of 70%. The children and their parents reported significantly lower HRQoL than 275 healthy age-matched children and their parents (P < .05). ConclusionsChildren with a history of infantile SBS have a lower HRQoL than healthy age-matched controls. This difference lasts beyond childhood and way beyond the period of intestinal rehabilitation early in life. These findings highlight the need for targeted interventions to address these dimensions of impaired HRQoL.

Intestinal Failure‐Associated Metabolic Bone Diseases and Response to Teriparatide

Patients requiring home parenteral nutrition (PN) may develop metabolic bone disease, the etiology of which can be multifactorial. We report a case of significantly low bone mass in a postmenopausal woman with history of short bowel syndrome, renal impairment, and previous radiation exposure who responded to intermittent subcutaneous administration of parathyroid hormone. Her bone mineral density normalized after she completed a course of 18 months of treatment, and a bone isotope scan was negative for skeletal malignancy.

D-Lactic Acidosis in Humans: Review of Update

D-Lactic acidosis has been well documented in ruminants. In humans, D-lactic acidosis is very rare, but D-lactic acidosis may be more common than generally believed and should be looked for in a case of metabolic acidosis in which the cause of acidosis is not apparent. The clinical presentation of D-lactic acidosis is characterized by episodes of encephalopathy and metabolic acidosis. The entity should be considered as a diagnosis in a patient who presents with metabolic acidosis accompanied by high anion gap, normal lactate level, negative Acetest, history of short bowel syndrome or malabsorption, and characteristic neurologic manifestations. Low carbohydrate diet, bicarbonate treatment, rehydration, and oral antibiotics would be helpful in controlling symptoms.

Intestinal failure and small bowel transplantation, including clinical nutrition: Working Group report of the second World Congress of Pediatric Gastroenterology, Hepatology, and Nutrition.

Research Epidemiology and natural history of short bowel syndrome and intestinal failure. Basic and translational research in intestinal failure. Basic and translational research in small bowel transplantation. Intervention Decreasing the incidence of intestinal failure. Reducing the economic impact of intestinal failure. Reducing the economic impact of intestinal transplantation. Education Education of patients and families in the principles of intestinal rehabilitation. Education of primary practitioners, house officers and medical students in basic nutrition and nutritional rehabilitation. Education of a cadre of highly specialized nurses, nutritionists and physicians in the subtleties of medical and surgical therapy of patients with intestinal failure.

Intestinal Failure and Small Bowel Transplantation, Including Clinical Nutrition: Working Group Report of the Second World Congress of Pediatric Gastroenterology, Hepatology, and Nutrition

Research Epidemiology and natural history of short bowel syndrome and intestinal failure. Basic and translational research in intestinal failure. Basic and translational research in small bowel transplantation. Intervention Decreasing the incidence of intestinal failure. Reducing the economic impact of intestinal failure. Reducing the economic impact of intestinal transplantation. Education Education of patients and families in the principles of intestinal rehabilitation. Education of primary practitioners, house officers and medical students in basic nutrition and nutritional rehabilitation. Education of a cadre of highly specialized nurses, nutritionists and physicians in the subtleties of medical and surgical therapy of patients with intestinal failure.