A Simple Guide to Short Bowel Syndrome, Diagnosis, Treatment and Related Conditions

By Kenneth Kee

This book describes Short Bowel Syndrome, Diagnosis and Treatment and Related Diseases

"A short bowel means that the person must eat less at every meal or take 4 to 5 small meals every day"

Short bowel syndrome is a disorder in which some section of the small or large intestine has been removed or does not function properly.

As a result, people with short bowel syndrome cannot properly absorb nutrients, such as:
1. Vitamins
2. Minerals
3. Proteins
4. Fats

Some patients with short bowel syndrome have mild presentations while others develop far more difficulties.

Some patients have this disorder as a complication linked to birth defects.

Other times short bowel syndrome develops in adulthood.

Short bowel syndrome (SBS) in adults is depicted as less than 180 to 200 centimeters of remaining small bowel (normal length 275 to 850 cm) resulting in the need for nutritional and fluid supplements.

The normal length of small bowel in an adult, beginning from the duodenojejunal flexure, is between 275 to 850 centimeters.

About 9 liters of fluid pass through the small bowel every day in the form of oral fluids, saliva, gastric, biliary, and pancreatic secretions.

On average, about 7 liters of those fluids are taken up in the small bowel and 2 liters in the large bowel.

The large, healthy bowel obtains up about 150 kilocalories per day but can obtain up to 1000 kilocalories per day in those patients with malabsorption.

The absorption of most nutrients happens in the first 100 centimeters of the jejunum.

B12 and bile salts are taken in the last 100 centimeters of the ileum; magnesium is taken in the terminal ileum and proximal colon; water and sodium absorption happen throughout the bowel.

Patients manifest with signs and symptoms of malabsorption such as weight loss, diarrhea, steatorrhea, dehydration, malnutrition, and electrolyte imbalance.

Patients are treated using either lifelong parenteral nutrition or intestinal transplantation.

While there is no accepted guideline for SBS in children, the requirement for intravenous supplementation when having less than 25% of remaining small bowel that is expected for gestational age has been indicated.

About 75% of cases of SBS develop after a single large resection of bowel.

In the remaining 25% SBS happen after multiple resections.

Around 66% of patients who develop SBS survive their early hospitalization, and a similar number survive their first year after developing SBS.

The age and underlying disorder mainly determine a patient's long-term prognosis.

Most often short bowel syndrome develops after surgical removal of a section of the small intestine.

This surgery is performed to treat different types of intestinal disorders such as:

1. Being born with a narrowed small intestine, or missing a section of this part of the digestive system (intestinal atresia)
2. Injury to the intestines from physical trauma
3. Sluggish movement within the intestines
4. Cancer or cancer treatment that affects the intestines
5. Scarring of the intestines due to Crohn’s disease, producing obstruction in the digestive tract
6. Loss of blood flow to the intestines as a result of blood vessel blockage

SBS can happen from extensive surgical resection or congenital intestinal diseases.

The most frequent pathologies that lead to SBS in adults are:
1. Crohn disease
2. Mesenteric ischemia
3. Radiation enteritis

The most frequent symptoms are:
1. Malnutrition
2. Weight loss
3. Diarrhea
4. Electrolyte imbalance

Proper nutrition is the first treatment for people with short bowel syndrome.

Medicines and surgery is sometimes needed if proper nutrition treatment fails.

TABLE OF CONTENT
Introduction
Chapter 1 Short Bowel Syndrome
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4

• Language: English
• Publisher: Kenneth Kee
• Release date: Apr 18, 2021
• ISBN: 9781005973377

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

A

Simple

Guide

To

Short Bowel Syndrome,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2021 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes Short Bowel Syndrome, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What You Need to Treat Short Bowel Syndrome)

This e-Book is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog: http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiography account of my journey as a medical student to family doctor on my other blog: http://afamilydoctorstale.blogspot.com.

This autobiography account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 800 eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical disorders.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

My diagnosis and treatment capability has improved tremendously from my continued education.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Short bowel syndrome

What is short bowel syndrome?

Short bowel syndrome is a disorder in which some section of the small or large intestine has been removed or does not function properly.

As a result, people with short bowel syndrome cannot properly absorb nutrients, such as:

1. Vitamins

2. Minerals

3. Proteins

4. Fats

Some patients with short bowel syndrome have mild presentations while others develop far more difficulties.

Some patients have this disorder as a complication linked to birth defects.

Other times short bowel syndrome develops in adulthood.

Short bowel syndrome (SBS) in adults is depicted as less than 180 to 200 centimeters of remaining small bowel (normal length 275 to 850 cm) resulting in the need for nutritional and fluid supplements.

The normal length of small bowel in an adult, beginning from the duodenojejunal flexure, is between 275 to 850 centimeters.

About 9 liters of fluid pass through the small bowel every day in the form of oral fluids, saliva, gastric, biliary, and pancreatic secretions.

On average, about 7 liters of those fluids are taken up in the small bowel and 2 liters in the large bowel.

The large, healthy bowel obtains up about 150 kilocalories per day but can obtain up to 1000 kilocalories per day in those patients with malabsorption.

The absorption of most nutrients happens in the first 100 centimeters of the jejunum.

B12 and bile salts are taken in the last 100 centimeters of the ileum; magnesium is taken in the terminal ileum and proximal colon; water and sodium absorption happen throughout the bowel.

Patients manifest with signs and symptoms of malabsorption such as weight loss, diarrhea, steatorrhea, dehydration, malnutrition, and electrolyte imbalance.

Patients are treated using either lifelong parenteral nutrition or intestinal transplantation.

While there is no accepted guideline for SBS in children, the requirement for intravenous supplementation when having less than 25% of remaining small bowel that is expected for gestational age has been indicated.

About 75% of cases of SBS develop after a single large resection of bowel.

In the remaining 25% SBS happen after multiple resections.

Around 66% of patients who develop SBS survive their early hospitalization, and a similar number survive their first year after developing SBS.

The age and underlying disorder mainly determine a patient's long-term prognosis.

What are the causes of short bowel syndrome?

Causes

Most often short bowel syndrome develops after surgical removal of a section of the small intestine.

This surgery is performed to treat different types of intestinal disorders such as:

1. Being born with a narrowed