Short bowel syndrome - Revision history

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2026-03-22T09:30:15Z

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	==Background==		==Background==
	*Short bowel syndrome (SBS) is a malabsorptive condition resulting from the loss of functional small intestinal length or absorptive capacity, typically defined as '''< 200 cm of remaining small bowel''' in adults (normal length 275–850 cm)<ref name="statpearls">Short Bowel Syndrome. In: ''StatPearls''. Treasure Island (FL): StatPearls Publishing; 2023. PMID 30860742.</ref>		*Short bowel syndrome (SBS) is a malabsorptive condition resulting from the loss of functional small intestinal length or absorptive capacity, typically defined as '''< 200 cm of remaining small bowel''' in adults (normal length 275–850 cm)<ref name="statpearls">Short Bowel Syndrome. In: ''StatPearls''. Treasure Island (FL): StatPearls Publishing; 2023. PMID 30860742.</ref>
	*Results in ~~'''~~intestinal failure~~'''~~ when the remaining bowel cannot sustain nutritional, fluid, and electrolyte needs without parenteral support		*Results in intestinal failure when the remaining bowel cannot sustain nutritional, fluid, and electrolyte needs without parenteral support
	*Etiologies in adults:		*Etiologies in adults:
	**Crohn's disease (most common cause requiring repeated resections)		**Crohn's disease (most common cause requiring repeated resections)
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	*Diarrhea / steatorrhea — high-volume, watery; may be > 2 L/day with end-jejunostomy		*Diarrhea / steatorrhea — high-volume, watery; may be > 2 L/day with end-jejunostomy
	*Malnutrition and weight loss		*Malnutrition and weight loss
	*Dehydration and ~~'''~~electrolyte derangements~~'''~~ (hyponatremia, hypokalemia, hypomagnesemia, hypocalcemia)		*Dehydration and electrolyte derangements (hyponatremia, hypokalemia, hypomagnesemia, hypocalcemia)
	*Fatigue, weakness		*Fatigue, weakness
	*Abdominal distension, bloating, cramping		*Abdominal distension, bloating, cramping
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	==Evaluation==		==Evaluation==
	===Workup===		===Workup===
	*BMP/CMP: Electrolytes (~~'''~~Na, K, Mg, Ca, Phos~~'''~~ — all frequently abnormal), BUN/creatinine (dehydration/renal injury), bicarbonate (acidosis), glucose, liver enzymes, albumin		*BMP/CMP: Electrolytes (Na, K, Mg, Ca, Phos — all frequently abnormal), BUN/creatinine (dehydration/renal injury), bicarbonate (acidosis), glucose, liver enzymes, albumin
	*Magnesium level: Often critically low; must be corrected before hypokalemia will respond to potassium replacement		*Magnesium level: Often critically low; must be corrected before hypokalemia will respond to potassium replacement
	*CBC: Anemia (B12 deficiency → macrocytic; iron deficiency → microcytic), leukocytosis if infection		*CBC: Anemia (B12 deficiency → macrocytic; iron deficiency → microcytic), leukocytosis if infection
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	===Diagnosis===		===Diagnosis===
	*SBS itself is a known condition — the ED role is to ~~'''~~identify the acute complication~~'''~~ bringing the patient in		*SBS itself is a known condition — the ED role is to identify the acute complication bringing the patient in
	*Key diagnostic patterns in SBS patients:		*Key diagnostic patterns in SBS patients:
	{\| class="wikitable"		{\| class="wikitable"
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	*Empiric IV antibiotics: Vancomycin + gram-negative coverage (cefepime or piperacillin-tazobactam); adjust based on cultures<ref name="bering"/>		*Empiric IV antibiotics: Vancomycin + gram-negative coverage (cefepime or piperacillin-tazobactam); adjust based on cultures<ref name="bering"/>
	*'''Do NOT routinely remove the line''' unless: hemodynamic instability/septic shock, tunnel infection, persistent bacteremia > 72 hours on appropriate antibiotics, or fungemia		*'''Do NOT routinely remove the line''' unless: hemodynamic instability/septic shock, tunnel infection, persistent bacteremia > 72 hours on appropriate antibiotics, or fungemia
	*These patients have ~~'''~~limited venous access~~'''~~ — line preservation is critical when possible; consult the patient's PN team or vascular access specialist		*These patients have limited venous access — line preservation is critical when possible; consult the patient's PN team or vascular access specialist

	===D-Lactic Acidosis===		===D-Lactic Acidosis===
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	===General Principles===		===General Principles===
	*~~'''~~Contact the patient's GI/nutrition/intestinal rehabilitation team~~'''~~ early — these patients often have complex management plans and established relationships with specialists		*Contact the patient's GI/nutrition/intestinal rehabilitation team early — these patients often have complex management plans and established relationships with specialists
	*'''Do not discontinue or modify parenteral nutrition''' without specialist guidance		*'''Do not discontinue or modify parenteral nutrition''' without specialist guidance
	*Loperamide / codeine phosphate: May be used to reduce stoma/stool output (often part of home regimen)		*Loperamide / codeine phosphate: May be used to reduce stoma/stool output (often part of home regimen)

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2026-03-19T16:12:00Z

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Ostermayer at 22:07, 13 March 2026

2026-03-13T22:07:48Z

← Revisión anterior		Revisión del 22:07 13 mar 2026
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	*[[D-lactic acidosis]]		*[[D-lactic acidosis]]
	*[[Dumping syndrome]]		*[[Dumping syndrome]]
	*[[Central Line Associated Blood Stream Infections\|CRBSI]]
	*[[Wernicke encephalopathy]]		*[[Wernicke encephalopathy]]
	*[[Renal stone]]		*[[Renal stone]]

Ostermayer at 22:06, 13 March 2026

2026-03-13T22:06:52Z

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Ostermayer: Prepared the page for translation

2026-01-04T23:58:11Z

Prepared the page for translation

← Revisión anterior		Revisión del 23:58 4 ene 2026
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			<languages/>
			<translate>

	==Background==		==Background==

	*Well-recognized complication of gastric bypass		*Well-recognized complication of gastric bypass
	*Rapid post-prandial gastric emptying, release of gastric hormones, splanchnic vasodilation		*Rapid post-prandial gastric emptying, release of gastric hormones, splanchnic vasodilation
	*Hyperinsulinemic and hypoglycemic state		*Hyperinsulinemic and hypoglycemic state


	==Clinical Features==		==Clinical Features==
	*[[Nausea/vomiting]], bloating, [[abdominal pain\|abdominal cramps]], [[diarrhea]], diaphoresis
			*[[Special:MyLanguage/Nausea/vomiting\|Nausea/vomiting]], bloating, [[Special:MyLanguage/abdominal pain\|abdominal cramps]], [[Special:MyLanguage/diarrhea\|diarrhea]], diaphoresis
	**Early dumping= symptoms 30-60min after a meal		**Early dumping= symptoms 30-60min after a meal
	**Late dumping= symptoms 1-3 hours after a meal		**Late dumping= symptoms 1-3 hours after a meal


	==Differential Diagnosis==		==Differential Diagnosis==

			</translate>
	{{Abdominal Pain DDX Diffuse}}		{{Abdominal Pain DDX Diffuse}}
			<translate>


	==Evaluation==		==Evaluation==
	*See [[Abdominal Pain]]
			*See [[Special:MyLanguage/Abdominal Pain\|Abdominal Pain]]
	*Diagnosis of exclusion		*Diagnosis of exclusion


	==Management==		==Management==

	*Dietary Modifications		*Dietary Modifications
	**Avoid highly concentrated foods		**Avoid highly concentrated foods
	**Separate eating and drinking		**Separate eating and drinking
	*[[Octreotide]]		*[[Special:MyLanguage/Octreotide\|Octreotide]]
	**Positive case reports		**Positive case reports


	==Disposition==		==Disposition==

	*Home if other diagnoses excluded and able to tolerate oral intake		*Home if other diagnoses excluded and able to tolerate oral intake


	==See Also==		==See Also==
	[[Gastric bypass surgery]]
			[[Special:MyLanguage/Gastric bypass surgery\|Gastric bypass surgery]]


	==External Links==		==External Links==


	==References==		==References==

	O'Brien M. Acute Abdominal Pain In: Tintinalli's Emergency Medicine. 7th ed. McGraw-Hill. 2011:Chapter 74		O'Brien M. Acute Abdominal Pain In: Tintinalli's Emergency Medicine. 7th ed. McGraw-Hill. 2011:Chapter 74
	<references/>		<references/>

	[[Category:GI]] [[Category:Surgery]]		[[Category:GI]] [[Category:Surgery]]
			</translate>

ClaireLewis at 00:12, 30 September 2019

2019-09-30T00:12:09Z

← Revisión anterior		Revisión del 00:12 30 sep 2019
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	*Rapid post-prandial gastric emptying, release of gastric hormones, splanchnic vasodilation		*Rapid post-prandial gastric emptying, release of gastric hormones, splanchnic vasodilation
	*Hyperinsulinemic and hypoglycemic state		*Hyperinsulinemic and hypoglycemic state

	==Clinical Features==		==Clinical Features==
	*Nausea, vomiting, bloating, abdominal cramps, diarrhea, diaphoresis		*[[Nausea/vomiting]], bloating, [[abdominal pain\|abdominal cramps]], [[diarrhea]], diaphoresis
	**Early dumping= symptoms 30-60min after a meal		**Early dumping= symptoms 30-60min after a meal
	**Late dumping= symptoms 1-3 hours after a meal		**Late dumping= symptoms 1-3 hours after a meal

	==Differential Diagnosis==		==Differential Diagnosis==
	[[Abdominal Pain ~~Differential (Comprehensive)]]~~		{{Abdominal Pain DDX Diffuse}}

	==Evaluation==		==Evaluation==
	~~===Work-up===~~		*See [[Abdominal Pain]]
	*~~Same as~~ [[Abdominal Pain]]
	*Diagnosis of exclusion		*Diagnosis of exclusion
	~~===Evaluation===~~


	==Management==		==Management==
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	**Avoid highly concentrated foods		**Avoid highly concentrated foods
	**Separate eating and drinking		**Separate eating and drinking
	*Octreotide		*[[Octreotide]]
	**Positive case reports		**Positive case reports

	==Disposition==		==Disposition==
	*Home if other diagnoses excluded and able to tolerate oral intake		*Home if other diagnoses excluded and able to tolerate oral intake

	==See Also==		==See Also==
	[[Gastric bypass surgery]]		[[Gastric bypass surgery]]

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-25T15:50:15Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Revisión anterior		Revisión del 15:50 25 jul 2016
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	[[Abdominal Pain Differential (Comprehensive)]]		[[Abdominal Pain Differential (Comprehensive)]]

	==~~Diagnosis~~==		==Evaluation==
	===Work-up===		===Work-up===
	*Same as [[Abdominal Pain]]		*Same as [[Abdominal Pain]]

Hacharya: /* See Also */

2016-04-22T19:05:51Z

Ostermayer: Text replacement - "Category:Surg" to "Category:Surgery"

2016-03-22T16:18:37Z

Text replacement - "Category:Surg" to "Category:Surgery"

← Revisión anterior		Revisión del 16:18 22 mar 2016
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	<references/>		<references/>

	[[Category:GI]] [[Category:~~Surg~~]]		[[Category:GI]] [[Category:Surgery]]

Cchoff at 20:45, 20 October 2015

2015-10-20T20:45:25Z

← Revisión anterior		Revisión del 20:45 20 oct 2015
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	O'Brien M. Acute Abdominal Pain In: Tintinalli's Emergency Medicine. 7th ed. McGraw-Hill. 2011:Chapter 74		O'Brien M. Acute Abdominal Pain In: Tintinalli's Emergency Medicine. 7th ed. McGraw-Hill. 2011:Chapter 74
	<references/>		<references/>

			[[Category:GI]] [[Category:Surg]]

← Revisión anterior		Revisión del 19:05 22 abr 2016
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	*Home if other diagnoses excluded and able to tolerate oral intake		*Home if other diagnoses excluded and able to tolerate oral intake
	==See Also==		==See Also==
			[[Gastric bypass surgery]]

	==External Links==		==External Links==