Short bowel syndrome medical therapy

Short bowel syndrome Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Short bowel syndrome from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Study of Choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X-ray
Echocardiography and Ultrasound
CT scan
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Short bowel syndrome medical therapy On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Short bowel syndrome medical therapy All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Short bowel syndrome medical therapy
CDC on Short bowel syndrome medical therapy
Short bowel syndrome medical therapy in the news
Blogs on Short bowel syndrome medical therapy
Directions to Hospitals Treating Short bowel syndrome
Risk calculators and risk factors for Short bowel syndrome medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Medical Therapy

• Management of short bowel syndrome is complicated and requires close collaboration of all medical team members including the physician, nutritionist, and nurse with the patient and their families.
• Management of short bowel syndrome consists of medical therapy and surgical interventions.
• Medical therapy consists of nutritional therapy and pharmacotherapy.
• Lifelong follow-up is usually needed.

Nutritional therapy

• Nutritional therapy is essential for short bowel syndrome and to restore the intestinal adaptation. It could be provided through oral, enteral and parenteral routes.
  • 1 Fluid
    • 1.1 Acute phase
      • Preferred regimen (1): drug name 100 mg PO q12h for 10-21 days (Contraindications/specific instructions)
      • Preferred regimen (1): drug name 100 mg PO q12h for 10-21 days (Contraindications/specific instructions)
    • 1.2 Maintenance phase
      • Preferred regimen (1): drug name 100 mg PO q12h for 10-21 days (Contraindications/specific instructions)
      • Alternative regimen (1): drug name 500 mg PO q6h for 7–10 days
  • 2 Parenteral infusion
    • 2.1 Acute phase
      • 2.1.1 Diet
        • Preferred regimen (1): drug name 50 mg/kg PO per day q8h (maximum, 500 mg per dose)
        • Preferred regimen (2): drug name 30 mg/kg PO per day in 2 divided doses (maximum, 500 mg per dose)
        • Alternative regimen (1): drug name10 mg/kg PO q6h (maximum, 500 mg per day)
        • Alternative regimen (2): drug name 7.5 mg/kg PO q12h (maximum, 500 mg per dose)
      • 2.1.2 Electrolytes
    • 2.2 Maintenance phase
      • Preferred regimen (1): drug name 4 mg/kg/day PO q12h（maximum, 100 mg per dose）
      • Alternative regimen (1): drug name 10 mg/kg PO q6h (maximum, 500 mg per day)
      • Alternative regimen (2): drug name 7.5 mg/kg PO q12h (maximum, 500 mg per dose)
      • Alternative regimen (3): drug name 12.5 mg/kg PO q6h (maximum, 500 mg per dose)
  • 3 Enteral nutrition
    • 1.2.1 Adult
      • Preferred regimen (1): drug name 500 mg PO q8h
    • 1.2.2 Pediatric
      • Preferred regimen (1): drug name 50 mg/kg/day PO q8h (maximum, 500 mg per dose)
  • 4 Supplement
    • 4.1 Vitamins
    • 4.2 Minerals
    • 4.3 Exogenous enzyme replacement 
      • 4.3.1 Pancreatic enzyme
      • 4.3.2 Lactase
    • 4.4 Bile acid sequestrants

Pharmacotherapy

Symptoms of short bowel syndrome are usually addressed by prescription medicine. These include:

• Anti-diarrheal medicine (e.g. loperamide, codeine)
• Vitamin and mineral supplements
• H2 blocker and proton pump inhibitors to reduce stomach acid
• Lactase supplement (to improve the bloating and diarrhoea associated with lactose intolerance)
• Parenteral nutrition (PN or TPN - nutrition administered via intravenous line).
• Nutrition administered via gastronomy tube