Short bowel syndrome natural history, complications and prognosis: Difference between revisions
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Patients with short bowel syndrome may have complications caused by malabsorption of vitamins and minerals, such as deficiencies in [[vitamin]]s [[vitamin A|A]], [[vitamin D|D]], [[vitamin E|E]], [[vitamin K|K]], and [[vitamin B12|B12]], [[calcium in biology|calcium]], [[magnesium]], [[iron]], [[folic acid]], and [[zinc]]. These may appear as [[anemia]], [[hyperkeratosis]] (scaling of the skin), easy [[bruising]], [[muscle spasms]], poor [[blood clotting]], and [[bone pain]]. | Patients with short bowel syndrome may have complications caused by malabsorption of vitamins and minerals, such as deficiencies in [[vitamin]]s [[vitamin A|A]], [[vitamin D|D]], [[vitamin E|E]], [[vitamin K|K]], and [[vitamin B12|B12]], [[calcium in biology|calcium]], [[magnesium]], [[iron]], [[folic acid]], and [[zinc]]. These may appear as [[anemia]], [[hyperkeratosis]] (scaling of the skin), easy [[bruising]], [[muscle spasms]], poor [[blood clotting]], and [[bone pain]]. | ||
==Prognosis== | |||
There is no cure for short bowel syndrome. In newborn infants, the 4-year survival rate on [[Total parenteral nutrition|parenteral nutrition]] is approximately 70%. Some studies suggest that much of the mortality is due to a complication of the TPN, especially [[chronic liver disease]].<ref>{{cite journal |author=Vanderhoof JA, Langnas AN |title=Short-bowel syndrome in children and adults |journal=Gastroenterology |volume=113 |issue=5 |pages=1767-78 |year=1997 |pmid=9352883 |doi=}}</ref> Much hope is vested in [[Omegaven]], a type of lipid TPN feed, in which recent case reports suggest the risk of liver disease is much lower.<ref>{{cite journal |author=Gura KM, Duggan CP, Collier SB, ''et al'' |title=Reversal of parenteral nutrition-associated liver disease in two infants with short bowel syndrome using parenteral fish oil: implications for future management |journal=Pediatrics |volume=118 |issue=1 |pages=e197-201 |year=2006 |pmid=16818533 |doi=10.1542/peds.2005-2662}}</ref> | |||
Although promising, small intestine transplant has a mixed success rate, with postoperative mortality rate of up to 30%. One-year and 4-year survival rate are 90% and 60%, respectively. | |||
==References== | ==References== | ||
Revision as of 14:17, 5 September 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Complications
Patients with short bowel syndrome may have complications caused by malabsorption of vitamins and minerals, such as deficiencies in vitamins A, D, E, K, and B12, calcium, magnesium, iron, folic acid, and zinc. These may appear as anemia, hyperkeratosis (scaling of the skin), easy bruising, muscle spasms, poor blood clotting, and bone pain.
Prognosis
There is no cure for short bowel syndrome. In newborn infants, the 4-year survival rate on parenteral nutrition is approximately 70%. Some studies suggest that much of the mortality is due to a complication of the TPN, especially chronic liver disease.[1] Much hope is vested in Omegaven, a type of lipid TPN feed, in which recent case reports suggest the risk of liver disease is much lower.[2]
Although promising, small intestine transplant has a mixed success rate, with postoperative mortality rate of up to 30%. One-year and 4-year survival rate are 90% and 60%, respectively.
References
- ↑ Vanderhoof JA, Langnas AN (1997). "Short-bowel syndrome in children and adults". Gastroenterology. 113 (5): 1767–78. PMID 9352883.
- ↑ Gura KM, Duggan CP, Collier SB; et al. (2006). "Reversal of parenteral nutrition-associated liver disease in two infants with short bowel syndrome using parenteral fish oil: implications for future management". Pediatrics. 118 (1): e197–201. doi:10.1542/peds.2005-2662. PMID 16818533.