Short bowel syndrome secondary prevention: Difference between revisions
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==Overview== | ==Overview== | ||
There are several ways to prevent complications of short bowel syndrome. Management strategies and regular follow-up | There are several ways to prevent complications of short bowel syndrome. Management strategies and regular follow-up are needed to find and treat complications accordingly. | ||
==Secondary Prevention== | ==Secondary Prevention== | ||
*There are several ways to prevent complications of short bowel syndrome. | *There are several ways to prevent complications of short bowel syndrome. | ||
*Management strategies and regular follow-up | *Management strategies and regular follow-up are needed to find and treat complications accordingly. | ||
===Effective measures=== | ===Effective measures=== | ||
*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> | *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> | ||
Revision as of 14:01, 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 are 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 are 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.