Doctors still don't know exactly why some people have digestive problems. Ulcers, gastritis, reflux and defecation disorders have become part of the life of a modern person. 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 adjusting your diet and medication isn't enough. If the situation gets out of control, the patient is operated on.
Resection of the small intestine is one of the types of surgical intervention. Today, doctors try to resort to it only when absolutely necessary. The probability 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 the ability to digest food. The patient develops anemia and dehydration. A similar clinical picture describes the short bowel syndrome. Photos of pathology, as well as symptoms and treatments are presented in this article.
What is this disease?
Under short bowel syndromerefers to a whole symptom complex that occurs after resection of an organ. 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 sometimes occurs in children. If in the first case there is already a tactic of treatment that has been proven over the years, then with small patients the situation is somewhat more complicated. The mechanism of regeneration in children is highly active, so they recover faster and return to their usual rhythm of life. However, many drugs for young patients are categorically contraindicated. Short bowel syndrome in newborns is diagnosed extremely rarely, 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 identify two main factors contributing to the development of the syndrome. This is an operation to excise a part of the small intestine and a hereditary predisposition. Genetic mutations are a complex issue that requires highly specialized knowledge. So let's take a closer look at 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 departments are affected.
- Strangulation ileus. A dangerous disorder characterized by narrowing of the lumen of an organ and compression of nerve endings.
- Nekrotizing enterocolitis. Acute inflammation of the gastrointestinal tract, which can provoke a heart attack of the intestinal wall. This disorder occurs predominantly in premature babies. Among its main causes, doctors call intrauterine infection.
- Gastroschisis. One of the variants of a hernia, when part of the intestine "goes" out and begins to develop outside the abdominal wall.
- Various pathologies leading to damage to the vessels of the organ and slowing down blood flow.
Development mechanism
Short bowel syndrome, the treatment of which is discussed below, is a complex pathological process. It is customary to distinguish three stages in its course. 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, neurological disorders. Patients report constant weakness and drowsiness.
The work of the digestive system is gradually restored, a period of subcompensation begins. The chair is normalized, the metabolism comes into balance, but dryness of the skin remains. 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 condition. The 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 the study of history and questioning the patient. Physical examination revealed pallor of the skin, swelling. Palpation of the abdominal wall may be accompanied by pain. If short bowel syndrome is suspected, the symptoms of the disease are not the basis for confirming the diagnosis. Therefore, the patient is assigned a series of tests. Blood biochemistry can detect kidney failure, as well as determine the content of sodium and potassium. A general analysis is necessary to assess the level of hemoglobin. It also helps to detect an increase in ESR. If a septic lesion is suspected, a bacteriological blood culture is additionally prescribed.
Instrumental examination methods make it possible to detectcomplications that developed against the background of the pathological process. Among them, the most informative are ultrasound of the abdominal organs, X-ray of the intestine and FEGDS. The results of a medical examination help to assess 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 treatment methods, which include dietary changes and medications. Severe cases may require surgery.
Patients with a diagnosis of "short bowel syndrome" are shown a strict diet. It implies the exclusion from the diet of fatty and fried foods, alcoholic beverages. Doctors recommend giving preference to lean meals (lean meat, fish, vegetables and fruits, cereals on the water). To compensate for calcium deficiency, it is necessary to increase the amount of fermented milk 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 medication. Their use is necessary for the relief of clinical manifestations. Patients are prescribed antidiarrheal agents ("Loperamide"), vitamin complexes and medications to relieve symptoms of dehydration ("Regidron"). Forantacids are used to normalize the acidity of gastric juice. Surgical intervention is resorted to 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, the listed treatment options do not always bring the desired results. Especially often, an unfavorable prognosis is observed in children. 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 possibility of an unfavorable prognosis cannot be ruled out. What complications do patients face?
- Hypovitaminosis.
- Kidney and gallstones.
- Intestinal dysbacteriosis.
- Violation of bile synthesis.
Such violations worsen the general condition of the patient. However, competent treatment and constant monitoring by a gastroenterologist can achieve positive dynamics, speed up the recovery of the body.
