Short bowel syndrome secondary prevention: Difference between revisions
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==Overview== | ==Overview== | ||
There are | There are several ways to prevent complications of short bowel syndrome. Management strategies and regular follow-up is needed to find and treat complications accordingly. | ||
==Secondary Prevention== | ==Secondary Prevention== | ||
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*Management strategies and regular follow-up is needed to find and treat complications accordingly. | *Management strategies and regular follow-up is needed to find and treat complications accordingly. | ||
===Effective measures=== | ===Effective measures=== | ||
*Effective measures for the secondary prevention of liver disease following | *Effective measures for the secondary prevention of [[Hepato-biliary diseases|liver disease]] following [[total parenteral nutrition]] include:<ref name="RodriguesSeetharam2011">{{cite journal|last1=Rodrigues|first1=Gabriel|last2=Seetharam|first2=Prasad|title=Short bowel syndrome: A review of management options|journal=Saudi Journal of Gastroenterology|volume=17|issue=4|year=2011|pages=229|issn=1319-3767|doi=10.4103/1319-3767.82573}}</ref> | ||
**High calorie diet including less than 30% fat | **High calorie [[Diet (nutrition)|diet]] including less than 30% [[fat]] | ||
**Treating nutrient deficiencies | **Treating [[nutrient]] deficiencies | ||
**Treating small bowel bacterial overgrowth | **Treating [[Small bowel bacterial overgrowth syndrome|small bowel bacterial overgrowth]] | ||
**Ursodeoxycholic acid | **[[Ursodiol|Ursodeoxycholic acid]] | ||
**Regular monitoring of liver function tests | **Regular monitoring of [[liver function tests]] | ||
** | **Regular follow up with hepatobiliary [[ultrasound]] if [[liver function tests]] are abnormal | ||
** | **Performing [[liver biopsy]] if hepatobiliary [[ultrasound]] is abnormal | ||
*Effective measures for the secondary prevention of cholelithiasis following | *Effective measures for the secondary prevention of [[Gallstone disease|cholelithiasis]] following [[total parenteral nutrition]] include:<ref name="RodriguesSeetharam2011">{{cite journal|last1=Rodrigues|first1=Gabriel|last2=Seetharam|first2=Prasad|title=Short bowel syndrome: A review of management options|journal=Saudi Journal of Gastroenterology|volume=17|issue=4|year=2011|pages=229|issn=1319-3767|doi=10.4103/1319-3767.82573}}</ref> | ||
**Initiating enteral nutrition whenever feasible | **Initiating [[enteral nutrition]] whenever feasible | ||
**Intermittent cholecystokinin and lipids injections | **Intermittent [[cholecystokinin]] and [[Lipid|lipids]] injections | ||
**Prophylactic cholecystectomy | **Prophylactic [[cholecystectomy]] | ||
*Effective measures for the secondary prevention of kidney stone following | *Effective measures for the secondary prevention of [[kidney stone]] following [[total parenteral nutrition]] include:<ref name="RodriguesSeetharam2011">{{cite journal|last1=Rodrigues|first1=Gabriel|last2=Seetharam|first2=Prasad|title=Short bowel syndrome: A review of management options|journal=Saudi Journal of Gastroenterology|volume=17|issue=4|year=2011|pages=229|issn=1319-3767|doi=10.4103/1319-3767.82573}}</ref> | ||
**Low oxalate diet | **Low [[oxalate]] [[Diet (nutrition)|diet]] | ||
**Minimizing intraluminal fat | **Minimizing [[Lumen (anatomy)|intraluminal]] [[fat]] | ||
**Providing calcium supplements | **Providing [[Calcium|calcium supplements]] | ||
**Maintaining a high urinary volume | **Maintaining a high [[Urinary system|urinary]] volume | ||
**Cholestyramine | **[[Cholestyramine]] | ||
*Effective measures for the secondary prevention of small bowel bacterial overgrowth following | *Effective measures for the secondary prevention of [[Small bowel bacterial overgrowth syndrome|small bowel bacterial overgrowth]] following [[total parenteral nutrition]] include:<ref name="RodriguesSeetharam2011">{{cite journal|last1=Rodrigues|first1=Gabriel|last2=Seetharam|first2=Prasad|title=Short bowel syndrome: A review of management options|journal=Saudi Journal of Gastroenterology|volume=17|issue=4|year=2011|pages=229|issn=1319-3767|doi=10.4103/1319-3767.82573}}</ref> | ||
**Long term antibiotic therapy | **Long term [[Antibiotic|antibiotic therapy]] | ||
*Effective measures for the secondary prevention of lactic acidosis include:<ref name="WilmoreRobinson2014">{{cite journal|last1=Wilmore|first1=Douglas W.|last2=Robinson|first2=Malcolm K.|title=Short Bowel Syndrome|journal=World Journal of Surgery|volume=24|issue=12|year=2014|pages=1486–1492|issn=0364-2313|doi=10.1007/s002680010266}}</ref> | *Effective measures for the secondary prevention of [[lactic acidosis]] include:<ref name="WilmoreRobinson2014">{{cite journal|last1=Wilmore|first1=Douglas W.|last2=Robinson|first2=Malcolm K.|title=Short Bowel Syndrome|journal=World Journal of Surgery|volume=24|issue=12|year=2014|pages=1486–1492|issn=0364-2313|doi=10.1007/s002680010266}}</ref> | ||
**Hydration | **[[Hydration reaction|Hydration]] | ||
**Antibiotic therapy | **[[Antibiotic|Antibiotic therapy]] | ||
*Effective measures for the secondary prevention of osteoporosis include: | *Effective measures for the secondary prevention of osteoporosis include: | ||
** | **Providing [[vitamin D]] and [[Calcium|calcium supplements]] | ||
===Follow-up=== | ===Follow-up=== | ||
*Close long-term follow-up is needed. | *Close long-term follow-up is needed. | ||
*Monitoring and measuring blood levels of nutrients are required.<ref name="WilmoreRobinson2014">{{cite journal|last1=Wilmore|first1=Douglas W.|last2=Robinson|first2=Malcolm K.|title=Short Bowel Syndrome|journal=World Journal of Surgery|volume=24|issue=12|year=2014|pages=1486–1492|issn=0364-2313|doi=10.1007/s002680010266}}</ref> | *Monitoring and measuring blood levels of [[Nutrient|nutrients]] are required.<ref name="WilmoreRobinson2014">{{cite journal|last1=Wilmore|first1=Douglas W.|last2=Robinson|first2=Malcolm K.|title=Short Bowel Syndrome|journal=World Journal of Surgery|volume=24|issue=12|year=2014|pages=1486–1492|issn=0364-2313|doi=10.1007/s002680010266}}</ref> | ||
Table below summarizes the tests and imaging studies which are required in patients with short bowel syndrome when discharge from the hospital. | Table below summarizes the tests and imaging studies which are required in patients with short bowel syndrome when discharge from the hospital. | ||
{| class="wikitable" | {| class="wikitable" | ||
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|- | |- | ||
|Weight | |Weight | ||
|Every week to check for malnutrition and dehydration | |Every week to check for [[malnutrition]] and [[dehydration]] | ||
|- | |- | ||
|Intake and output | |Intake and output | ||
|Every 1 to 4 weeks to check for malnutrition and dehydration | |Every 1 to 4 weeks to check for [[malnutrition]] and [[dehydration]] | ||
|- | |- | ||
|Comprehensive metabolic panel including magnesium | |Comprehensive metabolic panel including [[magnesium]] | ||
|Every 4 weeks to check for malnutrition and dehydration | |Every 4 weeks to check for [[malnutrition]] and [[dehydration]] | ||
|- | |- | ||
|Essential fatty acids | |[[Essential fatty acid|Essential fatty acids]] | ||
|Every 6 to 12 months to check for malnutrition | |Every 6 to 12 months to check for [[malnutrition]] | ||
|- | |- | ||
|Vitamin levels | |[[Vitamin]] levels | ||
|Every 6 to 12 months to check for malnutrition | |Every 6 to 12 months to check for [[malnutrition]] | ||
|- | |- | ||
|Minerals | |[[Mineral|Minerals]] | ||
|Every 6 to 12 months to check for malnutrition | |Every 6 to 12 months to check for [[malnutrition]] | ||
|- | |- | ||
|Liver function tests | |[[Liver function tests]] | ||
|Every 6 months to check for liver disease | |Every 6 months to check for [[Hepato-biliary diseases|liver disease]] | ||
|- | |- | ||
|Dual-energy x-ray absorptiometry | |[[Dual energy X-ray absorptiometry|Dual-energy x-ray absorptiometry scan]] | ||
|Every 2 years to check for osteoporosis | |Every 2 years to check for [[osteoporosis]] | ||
|} | |} | ||
Revision as of 13:59, 11 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
There are several ways to prevent complications of short bowel syndrome. Management strategies and regular follow-up is needed to find and treat complications accordingly.
Secondary Prevention
- There are several ways to prevent complications of short bowel syndrome.
- Management strategies and regular follow-up is needed to find and treat complications accordingly.
Effective measures
- Effective measures for the secondary prevention of liver disease following total parenteral nutrition include:[1]
- High calorie diet including less than 30% fat
- Treating nutrient deficiencies
- Treating small bowel bacterial overgrowth
- Ursodeoxycholic acid
- Regular monitoring of liver function tests
- Regular follow up with hepatobiliary ultrasound if liver function tests are abnormal
- Performing liver biopsy if hepatobiliary ultrasound is abnormal
- Effective measures for the secondary prevention of cholelithiasis following total parenteral nutrition include:[1]
- Initiating enteral nutrition whenever feasible
- Intermittent cholecystokinin and lipids injections
- Prophylactic cholecystectomy
- Effective measures for the secondary prevention of kidney stone following total parenteral nutrition include:[1]
- Low oxalate diet
- Minimizing intraluminal fat
- Providing calcium supplements
- Maintaining a high urinary volume
- Cholestyramine
- Effective measures for the secondary prevention of small bowel bacterial overgrowth following total parenteral nutrition include:[1]
- Long term antibiotic therapy
- Effective measures for the secondary prevention of lactic acidosis include:[2]
- Effective measures for the secondary prevention of osteoporosis include:
- Providing vitamin D and calcium supplements
Follow-up
- Close long-term follow-up is needed.
- Monitoring and measuring blood levels of nutrients are required.[2]
Table below summarizes the tests and imaging studies which are required in patients with short bowel syndrome when discharge from the hospital.
Measurement | Frequency |
---|---|
Clinic visit | Every 6 to 12 months |
Weight | Every week to check for malnutrition and dehydration |
Intake and output | Every 1 to 4 weeks to check for malnutrition and dehydration |
Comprehensive metabolic panel including magnesium | Every 4 weeks to check for malnutrition and dehydration |
Essential fatty acids | Every 6 to 12 months to check for malnutrition |
Vitamin levels | Every 6 to 12 months to check for malnutrition |
Minerals | Every 6 to 12 months to check for malnutrition |
Liver function tests | Every 6 months to check for liver disease |
Dual-energy x-ray absorptiometry scan | Every 2 years to check for osteoporosis |
References
- ↑ 1.0 1.1 1.2 1.3 Rodrigues, Gabriel; Seetharam, Prasad (2011). "Short bowel syndrome: A review of management options". Saudi Journal of Gastroenterology. 17 (4): 229. doi:10.4103/1319-3767.82573. ISSN 1319-3767.
- ↑ 2.0 2.1 Wilmore, Douglas W.; Robinson, Malcolm K. (2014). "Short Bowel Syndrome". World Journal of Surgery. 24 (12): 1486–1492. doi:10.1007/s002680010266. ISSN 0364-2313.