Clinical Nutrition II:
Short Bowel Syndrome

CTP 16

Table of Contents

1. Title Slide
2. Underlying Conditions Responsible for Bowel Resection
3. Definition of the Short Bowel Syndrome
4. Sites of Nutrient Absorption
5. Overview of Fluid Movement in the Intestine
6. Fluid Movement in the Intestine
7. Nutrient and Sodium Transport Proteins in the Jejunum
8. Cell Model of Sodium-Coupled Glucose Uptake in the Small Intestine
9. Fluid Movement in the Intestine Following Hypertonic Intake
10. Determinants of Fluid Absorption in the Intestine
11. Intestinal Adaptation Following Resection
12. Barium X-ray of Normal Small Bowel
13. Barium X-ray of a Short Bowel
14. Stimulators of Intestinal Hyperplasia Following Resection
15. Ileal Hyperplasia and Increased Glucose Transport Following Intestinal Resection
16. The Importance of Luminal Nutrients in Preserving Small Bowel Mass
17. Stimulators and Inhibitors of Intestinal Hyperplasia
18. Therapies Under Investigation to Enhance Intestinal Adaptation
19. Mechanisms of Malabsorption in the Short Bowel Syndrome
20. Clinical Consequences of Malabsorption
21. Manifestations of Vitamin and Mineral Deficiencies
22. Characteristics of Jejunal Resection
23. Factors that Determine Severity
24. Characteristics of Ileal Resection
25. Characteristics of Extensive Bowel Resection
26. Pitfalls and Warnings in Management
27. Types of Bowel Resections
28. Summary of Types of Bowel Resection, Characteristics and Prognosis
29. Early Management of the Short Bowel Syndrome
30. Long-Term Management - Jejunal Resection
31. Long-Term Management - Limited Ileal Resection (<100 cm resected)
32. Length of Ileal Resection, Degree of Steatorrhea and Response to Cholestyramine
33. Long-Term Management >100 cm Ileal Resection
34. Long-Term Management - Extensive Bowel Resection and Colon Present
35. Long-Term Management - Extensive Bowel Resection and Colon Absent
36. Monitoring - Extensive Bowel Resection
37. Importance of Preservation of the Colon.
38. Carbohydrate Salvage in the Colon
39. Dietary Management After Extensive Resection - High Fat vs High Carbohydrate Diet
40. Dietary Management After Extensive Resection - Effects of Diet on Fecal Output
41. Enhancing Calorie Absorption in the Short Bowel Syndrome
42. Long-Chain Triglyceride (LCT) and Medium-Chain Triglyceride (MCT) Absorption
43. Graph of Fluid Balance Following Extensive Intestinal Resection
44. Perfusion Study of Isotonic Sodium and Glucose Solutions in Human Jejunum
45. Absorption of Isotonic Solutions in the Jejunum
46. Composition of Oral Solutions
47. Importance of Sodium Concentration in Oral Solutions When Only Jejunum Remains
48. Relationship of Zinc Loss to Fecal Fluid Loss
49. Diarrhea Causes Zinc deficiency and Zinc Deficiency Causes Diarrhea
50. Short Bowel Syndrome-Vitamin Deficiencies
51. Short Bowel Syndrome-Mineral Deficiencies
52. Actions and Side Effects of Octreotide
53. Optimizing Drug Delivery in the Short Bowel Syndrome
54. Tube Feeding to Provide Supplemental Calories
55. Home Parenteral Nutrition - Underlying Diseases
56. Types of Long-Term Central Catheters
57. Long-term Central Catheter for Home Parenteral Nutrition
58. X-Ray of a Subclavian Central Catheter \
59. X-Ray of a Direct TransLumbar Central Catheter
60. X-Ray of a Direct TransHepatic Central Catheter
61. Complications of Long-Term Parenteral Nutrition
62. Central Catheter Related Complications
63. Home Parenteral Nutrition Line Infection - Microorganisms
64. Management of Line Infection in the Home Parenteral Nutrition Patient
65. Hepatobiliary Disease and the Short Bowel Syndrome
66. Canalicular and Intracellular Cholestasis
67. Portal Fibrosis (Trichrome Stain)
68. Portal Fibrosis (Trichrome Stain)
69. Macrovesicular Steatosis
70. Non-Alcoholic Steatohepatitis (NASH)
71. Proposed Mechanisms for Parenteral Nutrition-Related Hepatobiliary Disease
72. Monitoring - Home Parenteral Nutrition
73. Treatment of Parenteral Nutrition-Related Liver Disease
74. Home Parenteral Nutrition Survival Curves
75. Indications for Intestinal Transplant
76. Intestinal Transplant Milestones
77. Outcome - Home Parenteral Nutrition vs Small Bowel Transplant
78. Long-Term Complications of the Short Bowel Syndrome
79. Normal Vitamin D Metabolism
80. Consequences of Vitamin D and Calcium Malabsorption
81. X-Ray of Osteomalacia
82. X-Rays of Osteomalacia and Osteoporosis
83. Causes of Parenteral Nutrition-Related Bone Disease
84. Causes of Bone Mineral Loss in the Short Bowel Syndrome
85. Screening for Bone Disease in Short Bowel Patients
86. Interpreting Bone Density Studies
87. Biochemical Findings to Suggest Bone Disease
88. Example of a Bone Densitometry Study in a Short Bowel Patient
89. Treatment of Bone Loss
90. Skin Rash due to Zinc Deficiency
91. Magnesium Repletion in the Short Bowel Syndrome
92. Enteric Hyperoxaluria
    

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