Short bowel syndrome

* mc disorders ① massive intestinal resection

② regional enteritis c multiple bowel resection

③ jejunoileal bypass for morbid obesity

proximal duodenum, ileum distal 1/2, IC valve가 spare되면 small bowel 40-50%

resection해도 well tolerable.

그러나 ileum, IC valve resection하면 30%미만을 resection했더라도 severe diarrhea,

malabsorption유발.

* 치료

① diet > 2500 Cal

CHO, protein위주로 하고 fat은 40g/d 이하로 제한

② vit, mineral, 필수지방산 공급

③ diarreha control : loperamide, codeine등

④ bile salt-sequestering agent(cholestyramine)

⑤ gastric acid hypersecretion

: 일시적, pancreatic enzyme inactivation, pancreatic secretion dilution

-> H2 blocker, PPI가 유용