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