Doctors still can’t say exactly why some people have problems with the digestive tract. Ulcers, gastritis, reflux, and defecation are firmly embedded in the life of modern man. Therefore, many do not pay due attention to disorders. In most cases, the course of the disease can be stopped by stopping its manifestations. Sometimes adjustments to nutrition and medication are not enough. If the situation gets out of control, the patient undergoes surgery.
Small bowel resection is a type of surgical intervention. Today, doctors are trying to resort to it only in case of emergency. The likelihood of postoperative complications is extremely small, but not excluded. The length of the intestine after resection is reduced several times. As a result, the body loses its ability to digest food. The patient develops anemia and dehydration. A similar clinical picture describes short bowel syndrome. Photos of the pathology, as well as symptoms and treatment methods, are presented in this article.
What is this ailment?
Short bowel syndrome refers to a whole symptom complex that occurs after an organ resection. This operation is relatively safe. The likelihood of complications or death is negligible. However, minor physiological disturbances can lead to indigestion. Therefore, the rehabilitation period after resection is sometimes delayed for several months.
Short bowel syndrome is most often detected in adults, although this pathology is sometimes found in children. If in the first case there is already a treatment tactic proven over the years, then with small patients the situation is somewhat more complicated. The regeneration mechanism in children is highly active, so they recover faster and return to their usual rhythm of life. However, many drugs are strictly contraindicated in small patients. Short bowel syndrome in infants is extremely rarely diagnosed, but is also no exception. In this case, the main cause of the pathology lies not in surgical intervention, but in a genetic predisposition. What other factors contribute to the development of the syndrome?
Causes of pathology
Doctors distinguish two main factors contributing to the development of the syndrome. This is an operation to excise part of the small intestine and a hereditary predisposition. Genetic mutations are a complex issue that requires highly specialized knowledge. Therefore, we dwell in more detail on the second reason. What diseases and disorders require resection?
- Neoplasms of various etiologies.
- Crohn's disease. Nonspecific granulomatous lesion of the digestive tract, in which all its parts are affected.
- Strangulation bowel obstruction. A dangerous disorder characterized by narrowing of the lumen of the organ and compression of the nerve endings.
- Necrotizing enterocolitis. Acute inflammation of the gastrointestinal tract, which can provoke a heart attack of the intestinal wall. This disorder occurs mainly in premature babies. Among its main causes, doctors call intrauterine infection.
- Gastroschisis. One of the options for a hernia is when part of the intestine “comes out” and begins to develop outside the abdominal wall.
- Various pathologies leading to damage to the vessels of the organ and slowing blood flow.
Development mechanism
Short bowel syndrome, the treatment of which is discussed below, is a complex pathological process. In its course, it is customary to distinguish three stages. After surgery, an acute postoperative period begins. Its duration is several weeks or months. This stage is characterized by the appearance of loose stools, dehydration, and neurological disorders. Patients report persistent weakness and drowsiness.
The digestive system is gradually recovering, a period of subcompensation begins. The stool is normalized, the metabolism is balanced, but the skin is dry. The body is deficient in vitamins and minerals, anemia develops. The duration of this period is about a year.
The last stage is adaptation. Its duration depends on the volume of surgical interventions and the individual characteristics of the patient's body.
Symptoms and manifestations of the syndrome
Clinical signs of pathology depend on the severity of the syndrome. The course of the disease in a mild form is usually accompanied by abdominal pain, diarrhea and flatulence. The average degree is characterized by a more pronounced clinical picture. Patients complain of frequent loose stools (up to 7 times a day), weight loss, poor skin and hair. A severe degree of the syndrome is considered the most unfavorable. It is manifested by debilitating diarrhea (up to 15 times a day), anemia and rapid weight loss.
Medical examination of patients
Diagnosis of pathology begins with a study of the history and questioning of the patient. A physical examination reveals pallor of the skin, swelling. Palpation of the abdominal wall may be accompanied by soreness. If you suspect a short bowel syndrome, the symptoms of the disease are not grounds for confirming the diagnosis. Therefore, the patient is assigned a number of tests. Blood biochemistry can detect renal failure, as well as determine the content of sodium and potassium. A general analysis is necessary to assess hemoglobin levels. It also helps to detect an increase in ESR. If you suspect a septic lesion, an additional bacteriological blood culture is prescribed.
Instrumental examination methods make it possible to detect complications that developed against the background of the pathological process. Among them, the most informative are ultrasound of the abdominal cavity, an x-ray of the intestine and FEGDS. The results of a medical examination help to evaluate the overall clinical picture of the disease, prescribe competent therapy.
How to treat short bowel syndrome in children and adults?
The intensity of the clinical manifestations of the pathology and the patient's well-being determine the therapeutic tactics. Doctors prefer to be guided by general methods of treatment, which include diet correction and medication. In especially serious cases, surgery may be required.
A patient with a diagnosis of “short bowel syndrome” is shown a strict diet. It implies the exclusion of fatty and fried foods, alcoholic beverages from the diet. Doctors recommend giving preference to lean dishes (lean meat, fish, vegetables and fruits, cereals on the water). To compensate for the deficiency of calcium, it is necessary to increase the number of dairy products. Whole milk in many patients provokes an increase in diarrhea, so it should be used with caution. Food is recommended to be steamed, but without the addition of spices and other flavor enhancers.
Short bowel syndrome cannot be cured without the use of drugs. Their use is necessary for the relief of clinical manifestations. Patients are prescribed antidiarrheal drugs (Loperamide), vitamin complexes and medications to relieve symptoms of dehydration (Regidron). Antacids are used to normalize the acidity of gastric juice. They resort to surgical intervention only with a complicated course of the disease, when conservative therapy is ineffective. This may be a transplant of part of the intestine or the creation of an artificial valve in the organ. Such operations are quite effective, but sometimes unpredictable.
Unfortunately, not always listed treatment options bring the desired results. Especially often, an unfavorable prognosis is observed in babies. In this case, patients are transferred to intravenous nutrition. After adaptation of the body, its concentration is gradually increased. This is a very lengthy process that requires several hospitalizations and patience on the part of the parents.
Possible complications
Short bowel syndrome is often accompanied by complications. Even with careful observance of the doctor’s recommendations, the probability of an unfavorable prognosis cannot be ruled out. What complications do patients have to face?
- Hypovitaminosis.
- Kidney stones and gall bladder.
- Intestinal dysbiosis.
- Violation of the synthesis of bile.
Such violations worsen the general condition of the patient. However, competent treatment and constant monitoring by a gastroenterologist can achieve positive dynamics, accelerate the recovery of the body.