Intestinal adaptation in patients with short bowel syndrome

Abstract

Functional adaptation of remaining intestine was evaluated in 30 patients with extensive small bowel resection. Calcium and xylose absorption tests were compared. Calcium absorption was measured by a double-radiotracer technique. Serum xylosemia was measured 2 hr after D-xylose ingestion. Patients were divided into two groups according to the time interval between surgery and evaluation: less (group I) or more (group II) than two years. A statistically significant correlation was found between xylosemia and remaining small bowel length (r = 0.71; P less than 0.001) and between calcium absorption and remaining small bowel length (r = 0.75; P less than 0.001) in group I. A significant correlation was also observed between calcium absorption and time after surgery (r = 0.65; P = 0.001) but not for xylose absorption. Calcium absorption value was significantly increased in group II patients compared with group I patients matched for remaining small bowel length (36.2 +/- 12.5% vs 14.5 +/- 9.1%; P less than 0.001) while no difference was observed between the two groups concerning xylose absorption. These data indicate that intestinal calcium absorption continues to increase for more than two years after a major bowel resection in man. The intestine does not seem to recover all its functions at the same time.

Effects of bowel rehabilitation and combined trophic therapy on intestinal adaptation in short bowel patients

“…As the patient's oral intake increased, the amount of TPN was reduced, the frequency of TPN was reduced to every other day for 1 week, three times in the next week, and twice during the third week or weaned from TPN at last [17] . If the patient lost or more 1 kg/week of body weight or more, if diarrhea exceeded 600 g/day or if laboratory abnormalities developed, then the patients were placed back on TPN [18] . In our group, 22 patients weaned from TPN among the 33 survived patients after receiving rehabilitation therapy.…”

Management of patients with a short bowel

“…glucose), water, sodium and calcium with time [15,18,19,66] , and an increased chance of the patient being able to stop parenteral nutrition [25,36,37,67] . The intestinal calcium absorption may continue to increase for more than two years after a resection [66] .…”

Tarm- og flerorgantransplantasjon ved kronisk tarmsvikt

“…Chronic intestinal failure develops only in connection with disease or damage to the small intestine. It is possible to function without the large intestine, but if the large intestine is preserved, the need to supply extra fluid and saline will be reduced (2). Intestinal transplantation is therefore only relevant when the small intestine fails.…”