Managing Secondary Effects of Short Bowel Syndrome

Loss of segments of the bowel can lead to imbalances and symptoms related to gastric acid, bacterial overgrowth, and bile salt malabsorption.

Managing Gastric Acid Hypersecretion

Gastric hypersecretion happens when the stomach produces too much acid. It must be addressed after significant resection of the small bowel. It will increase the volume of secretions entering the small bowel and increase acid in the upper gut.

Loss of segments in the small bowel results in a change in the levels of hormones involved with digestion (cholecystokinin or CCK, secretin, and gastrin) that results in continued acid secretion. This increased acid load causes erosion of the gut lining and an increased stool volume contributing to diarrhea, and electrolyte losses. In addition it alters pancreatic enzymes, and compromises bile salt function making them less effective.

The treatment for gastric hypersecretion is acid suppression through H2 blockers, and proton pump inhibitors (PPIs).

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