17 June 2011 (Friday) - Short Bowel Syndrome

Another diagnosis I'd not heard of before:
 

Short bowel syndrome is a malabsorption disorder usually caused by the small intestine being of unusually short length. Usually as a result of surgery, or more rarely due to the complete dysfunction of a large segment of bowel. The syndrome does not manifest unless more than two thirds of the small intestine have been removed or are absent.

Most cases are acquired (obviously!): short bowel syndrome caused by the surgical removal of a portion of the bowel may be a temporary condition, due to the adaptive property of the small intestine. Physiological changes to the remaining portion of the small intestine occur to increase its absorptive capacity. These changes include:

• Enlargement and lengthening of the villi
• Increase in the diameter of the small intestine
• Slow down in peristalsis through the small intestine

Some children are born with a congenital short bowel. In these cases the 4-year survival rate on parenteral nutrition is approximately 70%. In newborn infants with less than 10% of expected intestinal length, 5 year survival is approximately 20%.

Some studies suggest that much of the mortality is due to a complication of the TPN, especially chronic liver disease.

Although promising, small intestine transplant has a mixed success rate, with postoperative mortality rate of up to 30%. One-year and 4-year survival rate are 90% and 60%, respectively.

On further research I found that Giant Pandas effectively all have short bowel syndrome: having the gut of a carnivore and the diet of a herbivore....

Of professional relevance to me are the various nutritional anaemias that are far more likely to develop in SBS than in the average person, but personally I'm intrigued by the pandas...