Short bowel syndrome natural history, complications and prognosis: Difference between revisions
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*** [[Scurvy|Vitamin C deficiency]] that presents with [[bleeding]] tendency | *** [[Scurvy|Vitamin C deficiency]] that presents with [[bleeding]] tendency | ||
*** [[Vitamin D deficiency]] that presents with [[osteomalacia]] | *** [[Vitamin D deficiency]] that presents with [[osteomalacia]] | ||
*** Vitamin E deficiency that presents with neuropathy | *** [[Vitamin E deficiency]] that presents with [[neuropathy]] | ||
*** Vitamin K deficiency that presents with bleeding | *** [[Vitamin K deficiency]] that presents with [[bleeding]] | ||
** Mineral deficiency | ** Mineral deficiency | ||
*** Iron deficiency | *** [[Iron deficiency anemia|Iron deficiency]] | ||
*** Folic acid deficiency | *** [[Folate deficiency|Folic acid deficiency]] | ||
*** Calcium deficiency | *** [[Hypocalcemia|Calcium deficiency]] | ||
*** Zinc deficiency | *** [[Zinc deficiency]] | ||
*** Magnesium deficiency | *** [[Magnesium deficiency]] | ||
*** Selenium deficiency | *** [[Selenium deficiency]] | ||
*** Copper deficiency | *** [[Copper deficiency]] | ||
**Essential fatty acid deficiency | **[[Essential fatty acid]] deficiency | ||
* Surgery related complications | * [[Surgery]] related complications | ||
** General complications of surgery | ** General complications of [[surgery]] | ||
*** Thrombosis | *** [[Thrombosis]] | ||
*** Hemorrhage | *** [[Bleeding|Hemorrhage]] | ||
*** Wound infection | *** Wound [[infection]] | ||
*** Postoperative pulmonary atelectasis | *** Postoperative pulmonary [[atelectasis]] | ||
*** Acute kidney injury | *** [[Acute kidney injury]] | ||
*** Pulmonary embolism | *** [[Pulmonary embolism]] | ||
*** Deep vein thrombosis | *** [[Deep vein thrombosis]] | ||
** Surgery on | ** [[Surgery]] on [[Gastrointestinal tract|gastrointestinal system]] | ||
*** Anastomotic disruption | *** [[Anastomosis|Anastomotic]] disruption | ||
*** Anastomotic bleeding | *** [[Anastomosis|Anastomotic]] [[bleeding]] | ||
** Catheter related complications: | ** [[Catheter]] related complications: | ||
*** Infection of the central line | *** [[Infection]] of the central line | ||
*** Occlusion of the catheter due to thrombosis, fibrin formation, or precipitations | *** [[Occlusion]] of the [[catheter]] due to [[thrombosis]], [[fibrin]] formation, or [[Precipitation (chemistry)|precipitations]] | ||
*** Breakage of the central line | *** Breakage of the central line | ||
** Post bowel transplant complications: | ** Post [[Intestine|bowel]] [[Organ transplant|transplant]] complications: | ||
*** Acute rejection | *** Acute [[Transplant rejection|rejection]] | ||
*** Chronic rejection | *** Chronic [[Transplant rejection|rejection]] | ||
*** Hepatic, portal, or mesenteric vein thrombosis | *** [[Hepatic]], [[portal]], or [[mesenteric vein thrombosis]] | ||
*** Opportunistic infection, such as CMV, …. | *** [[Opportunistic infection]], such as [[Cytomegalovirus infection|CMV]], …. | ||
* Chronic complications | * Chronic complications | ||
** Gastrointestinal | ** [[Gastrointestinal tract|Gastrointestinal]] | ||
*** Small intestinal bacterial overgrowth due to stasis | *** [[Small intestinal bacterial overgrowth]] due to [[Stasis (medicine)|stasis]] | ||
*** Bowel obstruction | *** [[Bowel obstruction]] | ||
*** Bowel motor abnormalities | *** [[Intestine|Bowel]] motor abnormalities | ||
*** Stasis of intestinal contents | *** [[Stasis (medicine)|Stasis]] of [[Intestine|intestinal]] contents | ||
*** Parenteral nutrition liver disease from steatosis to fibrosis and cirrhosis | *** [[Total parenteral nutrition|Parenteral nutrition]] [[Hepato-biliary diseases|liver disease]] from [[steatosis]] to [[fibrosis]] and [[cirrhosis]] | ||
*** Bowel necrosis | *** [[Intestine|Bowel]] [[necrosis]] | ||
*** Peptic ulcers due to gastric hypersecretion | *** [[Peptic ulcer|Peptic ulcers]] due to [[Stomach|gastric]] hypersecretion | ||
*** Gallstones due to altered bile salt and bilirubin metabolism | *** Gallstones due to altered bile salt and bilirubin metabolism | ||
*** Hepatobiliary disease | *** Hepatobiliary disease | ||
Revision as of 18:42, 7 December 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]
Overview
If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
OR
Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
OR
Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
Natural History, Complications, and Prognosis
Natural History
- The symptoms of (disease name) usually develop in the first/ second/ third decade of life, and start with symptoms such as ___.
- The symptoms of (disease name) typically develop ___ years after exposure to ___.
- If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
Complications
Common complications of short bowel syndrome may be classified to different categories, including malnutrition, surgery related, and chronic complications.[1][2][3][4][5][6][7][8][9]
- Malnutrition
- Vitamin deficiency
- Vitamin A deficiency that presents with night blindness
- Vitamin B12 deficiency that presents with megaloblastic anemia
- Vitamin C deficiency that presents with bleeding tendency
- Vitamin D deficiency that presents with osteomalacia
- Vitamin E deficiency that presents with neuropathy
- Vitamin K deficiency that presents with bleeding
- Mineral deficiency
- Essential fatty acid deficiency
- Vitamin deficiency
- Surgery related complications
- General complications of surgery
- Thrombosis
- Hemorrhage
- Wound infection
- Postoperative pulmonary atelectasis
- Acute kidney injury
- Pulmonary embolism
- Deep vein thrombosis
- Surgery on gastrointestinal system
- Anastomotic disruption
- Anastomotic bleeding
- Catheter related complications:
- Infection of the central line
- Occlusion of the catheter due to thrombosis, fibrin formation, or precipitations
- Breakage of the central line
- Post bowel transplant complications:
- Acute rejection
- Chronic rejection
- Hepatic, portal, or mesenteric vein thrombosis
- Opportunistic infection, such as CMV, ….
- General complications of surgery
- Chronic complications
- Gastrointestinal
- Small intestinal bacterial overgrowth due to stasis
- Bowel obstruction
- Bowel motor abnormalities
- Stasis of intestinal contents
- Parenteral nutrition liver disease from steatosis to fibrosis and cirrhosis
- Bowel necrosis
- Peptic ulcers due to gastric hypersecretion
- Gallstones due to altered bile salt and bilirubin metabolism
- Hepatobiliary disease
- Lactose intolerance
- Permanent intestinal failure
- Extra-intestinal
- Kidney stone due to hyperoxaluria
- Metabolic bone disease
- Lactic acidosis
- Gastrointestinal
Prognosis
- There is no definite cure for short bowel syndrome. However, medications and nutritional therapy significantly improve the quality of life and survival of the patients.[10]
- Prognosis of short bowel syndrome depends on the location and size of the bowel resection, underlying pathology, nutrition and pharmacotherapy support, and extent of intestinal adaptation.[3][7][11]
- The quality of life for patients with short bowel syndrome depends on their ability to previous activities. Majority of them on effective treatment could have an excellent quality of life.[12]
- The 2 and 5-year survival rate of patients with short bowel syndrome are approximately 80% and 70%, respectively.[4]
- The 6-year survival rate of patients with short bowel syndrome is approximately 65% for patients who have remaining short bowel of more than 50 cm.[11]
- 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.[13]
- Although promising, the small intestine transplant has a mixed success rate, with a postoperative mortality rate of up to 30%. One-year and 4-year survival rates are 90% and 60%, respectively.[2]
References
- ↑ Wall, Elizabeth A. (2013). "An Overview of Short Bowel Syndrome Management: Adherence, Adaptation, and Practical Recommendations". Journal of the Academy of Nutrition and Dietetics. 113 (9): 1200–1208. doi:10.1016/j.jand.2013.05.001. ISSN 2212-2672.
- ↑ 2.0 2.1 Thompson, Jon S.; Weseman, Rebecca; Rochling, Fedja A.; Mercer, David F. (2011). "Current Management of the Short Bowel Syndrome". Surgical Clinics of North America. 91 (3): 493–510. doi:10.1016/j.suc.2011.02.006. ISSN 0039-6109.
- ↑ 3.0 3.1 Vanderhoof JA, Young RJ (2003). "Enteral and parenteral nutrition in the care of patients with short-bowel syndrome". Best Pract Res Clin Gastroenterol. 17 (6): 997–1015. PMID 14642862.
- ↑ 4.0 4.1 DiBaise JK, Young RJ, Vanderhoof JA (2004). "Intestinal rehabilitation and the short bowel syndrome: part 2". Am. J. Gastroenterol. 99 (9): 1823–32. doi:10.1111/j.1572-0241.2004.40836.x. PMID 15330926.
- ↑ Botey, Mireia; Alastrué, Antonio; Haetta, Henrik; Fernández-Llamazares, Jaume; Clavell, Arantxa; Moreno, Pau (2017). "Long-Term Results of Serial Transverse Enteroplasty with Neovalve Creation for Extreme Short Bowel Syndrome: Report of Two Cases". Case Reports in Gastroenterology. 11 (1): 229–240. doi:10.1159/000452734. ISSN 1662-0631.
- ↑ Keller J, Panter H, Layer P (2004). "Management of the short bowel syndrome after extensive small bowel resection". Best Pract Res Clin Gastroenterol. 18 (5): 977–92. doi:10.1016/j.bpg.2004.05.002. PMID 15494290.
- ↑ 7.0 7.1 Sundaram A, Koutkia P, Apovian CM (2002). "Nutritional management of short bowel syndrome in adults". J. Clin. Gastroenterol. 34 (3): 207–20. PMID 11873098.
- ↑ Tappenden KA (2014). "Pathophysiology of short bowel syndrome: considerations of resected and residual anatomy". JPEN J Parenter Enteral Nutr. 38 (1 Suppl): 14S–22S. doi:10.1177/0148607113520005. PMID 24500909.
- ↑ Limketkai BN, Parian AM, Shah ND, Colombel JF (2016). "Short Bowel Syndrome and Intestinal Failure in Crohn's Disease". Inflamm. Bowel Dis. 22 (5): 1209–18. doi:10.1097/MIB.0000000000000698. PMID 26818425.
- ↑ Kelly DG, Tappenden KA, Winkler MF (2014). "Short bowel syndrome: highlights of patient management, quality of life, and survival". JPEN J Parenter Enteral Nutr. 38 (4): 427–37. doi:10.1177/0148607113512678. PMID 24247092.
- ↑ 11.0 11.1 Eça, Rosário; Barbosa, Elisabete (2016). "Short bowel syndrome: treatment options". Journal of Coloproctology. 36 (4): 262–272. doi:10.1016/j.jcol.2016.07.002. ISSN 2237-9363.
- ↑ DiBaise JK, Young RJ, Vanderhoof JA (2004). "Intestinal rehabilitation and the short bowel syndrome: part 1". Am. J. Gastroenterol. 99 (7): 1386–95. doi:10.1111/j.1572-0241.2004.30345.x. PMID 15233682.
- ↑ 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.