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MALABSORPTION-BOWEL RESECTION

Gastroenterology

MALABSORPTION-BOWEL RESECTION

1. Massive resection of small bowel can cause malabsorption (short bowel syndrome), especially if the terminal ileum and ileocecal valve are resected.

2. The ileum absorbs nutrients, especially B 12 and bile acids.

3. > 60 cm of terminal ileum resected: B 12 deficiency.

4. < 100 cm of terminal ileum resected: bile acid uptake capacity is decreased, causing bile acid to make it to the colon and cause a bile acid-induced diarrhea.

5. > 100 cm of terminal ileum resected: bile acid uptake capacity is lost. Synthesis cannot keep up with loss, resulting in bile acid deficiency and subsequent fat malabsorption. Manage with cholestyramine.


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REFERENCES

1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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