Difference between revisions of "Short bowel syndrome pathophysiology"

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==Overview==
 
==Overview==
The exact pathogenesis of [disease name] is not fully understood.
 
 
OR
 
 
It is thought that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].
 
 
OR
 
 
[Pathogen name] is usually transmitted via the [transmission route] route to the human host.
 
 
OR
 
 
Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.
 
 
OR
 
 
 
[Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].
 
 
OR
 
 
The progression to [disease name] usually involves the [molecular pathway].
 
 
OR
 
 
The pathophysiology of [disease/malignancy] depends on the histological subtype.
 
  
 
==Pathophysiology==
 
==Pathophysiology==
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*The [[jejunum]], second portion of [[small intestine]], is responsible to absorb [[Nutrient|nutrients]]. The inner surface of the [[jejunum]] is covered in [[villus|villi]], which increase the surface area of [[Tissue (biology)|tissue]] available to absorb [[Nutrient|nutrients]] from the [[Gastrointestinal tract|gut]] contents. The [[Villus|villi]] in the [[jejunum]] are much longer than in the [[duodenum]] or [[ileum]]. It has many large [[circular folds]] in its [[submucosa]] called [[Circular folds|plicae circulares]], which increase the surface area for [[nutrient]] [[absorption]].
 
*The [[jejunum]], second portion of [[small intestine]], is responsible to absorb [[Nutrient|nutrients]]. The inner surface of the [[jejunum]] is covered in [[villus|villi]], which increase the surface area of [[Tissue (biology)|tissue]] available to absorb [[Nutrient|nutrients]] from the [[Gastrointestinal tract|gut]] contents. The [[Villus|villi]] in the [[jejunum]] are much longer than in the [[duodenum]] or [[ileum]]. It has many large [[circular folds]] in its [[submucosa]] called [[Circular folds|plicae circulares]], which increase the surface area for [[nutrient]] [[absorption]].
 
*The [[ileum]], third portion of [[small intestine]], is responsible to absorb [[vitamin B12]] and [[bile salts]] and whatever products of [[digestion]] that were not absorbed by the [[jejunum]]. Its surface is made up of folds, mainly [[villi]] and [[microvilli]]. Therefore the [[ileum]] has an extremely large surface area both for the [[adsorption]] of [[enzymes]] and for the [[absorption]] of products of [[digestion]]. The diffuse neuroendocrine system (DNES) [[Cell (biology)|cells]] that line the [[ileum]] contain the [[protease]] and [[carbohydrase]] [[enzymes]] ([[gastrin]], [[secretin]], [[cholecystokinin]]) responsible for the final stages of [[protein]] and [[carbohydrate]] [[digestion]].
 
*The [[ileum]], third portion of [[small intestine]], is responsible to absorb [[vitamin B12]] and [[bile salts]] and whatever products of [[digestion]] that were not absorbed by the [[jejunum]]. Its surface is made up of folds, mainly [[villi]] and [[microvilli]]. Therefore the [[ileum]] has an extremely large surface area both for the [[adsorption]] of [[enzymes]] and for the [[absorption]] of products of [[digestion]]. The diffuse neuroendocrine system (DNES) [[Cell (biology)|cells]] that line the [[ileum]] contain the [[protease]] and [[carbohydrase]] [[enzymes]] ([[gastrin]], [[secretin]], [[cholecystokinin]]) responsible for the final stages of [[protein]] and [[carbohydrate]] [[digestion]].
{| class="wikitable"
 
! colspan="4" |Gastrointestinal regulatory substances
 
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!Action
 
!Regulation
 
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===Pathogenesis===
 
===Pathogenesis===
 
*Short bowel syndrome is the result of [[bowel resection]] following various causes including [[Crohn's disease]], [[Cancer|malignancies]], [[ischemia]], and [[Physical trauma|trauma]].<ref name="pmid11873098">{{cite journal |vauthors=Sundaram A, Koutkia P, Apovian CM |title=Nutritional management of short bowel syndrome in adults |journal=J. Clin. Gastroenterol. |volume=34 |issue=3 |pages=207–20 |year=2002 |pmid=11873098 |doi= |url=}}</ref>
 
*Short bowel syndrome is the result of [[bowel resection]] following various causes including [[Crohn's disease]], [[Cancer|malignancies]], [[ischemia]], and [[Physical trauma|trauma]].<ref name="pmid11873098">{{cite journal |vauthors=Sundaram A, Koutkia P, Apovian CM |title=Nutritional management of short bowel syndrome in adults |journal=J. Clin. Gastroenterol. |volume=34 |issue=3 |pages=207–20 |year=2002 |pmid=11873098 |doi= |url=}}</ref>

Revision as of 22:26, 7 December 2017

Short bowel syndrome Microchapters

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Overview

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Causes

Differentiating Short bowel syndrome from other Diseases

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]

Overview

Pathophysiology

Physiology

Diagram of the small bowel 01. Source: Wikimedia.org By Cancer Research UK - Original email from CRUK, CC BY-SA 4.0,[1]

The small intestine has an average length of 5.5-6 meter and is responsible for digestion and absorption of food and nutrients. Three portions of small intestine are duodenum, jejunum, and ileum. There is an anatomic gradient for absorption throughout the gastrointestinal tract.[2][3]

Pathogenesis

Post bowel resection adaptation

Change Main features
Structural changes
Motility changes
  • Greater motility during the initial phase
  • Reduced motility during the adaptive phase
Functional changes
Intestinal adaptation
Phase Duration Main feature
Acute phase 1 to 3 months
Adaptive phase 1 to 2 years
Maintenance phase Following adaptive phase

Malabsorption

Associated Conditions

Short bowel syndrome might be associated with following pathologies:

Gross Pathology

Terminal ileum resected for Crohn's disease. By PPSE15 - Own work, CC BY-SA 4.0[12]
Partial Jejunum affected by morbus Crohn. Source: Wikimedia.org By Jaroslav Cehovsky - Camera, Public Domain[13]

Microscopic Pathology

References

  1. "File:Diagram of the small bowel 01 CRUK 045.svg - Wikimedia Commons". 
  2. 2.0 2.1 Tappenden KA (2014). "Pathophysiology of short bowel syndrome: considerations of resected and residual anatomy". JPEN J Parenter Enteral Nutr. 38 (1 Suppl): 14S–22S. PMID 24500909. doi:10.1177/0148607113520005. 
  3. Thomson, Alan B.R.; Drozdowski, Laurie; Iordache, Claudiu; Thomson, Ben K.A.; Vermeire, Severine; Clandinin, M. Tom; Wild, Gary (2003). Digestive Diseases and Sciences. 48 (8): 1546–1564. ISSN 0163-2116. doi:10.1023/A:1024719925058.  Missing or empty |title= (help)
  4. Sundaram A, Koutkia P, Apovian CM (2002). "Nutritional management of short bowel syndrome in adults". J. Clin. Gastroenterol. 34 (3): 207–20. PMID 11873098. 
  5. 5.0 5.1 Eça, Rosário; Barbosa, Elisabete (2016). "Short bowel syndrome: treatment options". Journal of Coloproctology. 36 (4): 262–272. ISSN 2237-9363. doi:10.1016/j.jcol.2016.07.002. 
  6. 6.0 6.1 Warner, Brad W. (2013). "Adaptation: Paradigm for the gut and an academic career". Journal of Pediatric Surgery. 48 (1): 20–26. ISSN 0022-3468. doi:10.1016/j.jpedsurg.2012.10.014. 
  7. Rowland, Kathryn J.; McMellen, Mark E.; Wakeman, Derek; Wandu, Wambul S.; Erwin, Christopher R.; Warner, Brad W. (2012). "Enterocyte expression of epidermal growth factor receptor is not required for intestinal adaptation in response to massive small bowel resection". Journal of Pediatric Surgery. 47 (9): 1748–1753. ISSN 0022-3468. doi:10.1016/j.jpedsurg.2012.03.089. 
  8. Matarese LE, O'Keefe SJ, Kandil HM, Bond G, Costa G, Abu-Elmagd K (2005). "Short bowel syndrome: clinical guidelines for nutrition management". Nutr Clin Pract. 20 (5): 493–502. PMID 16207689. doi:10.1177/0115426505020005493. 
  9. Wall, Elizabeth A. (2013). "An Overview of Short Bowel Syndrome Management: Adherence, Adaptation, and Practical Recommendations". Journal of the Academy of Nutrition and Dietetics. 113 (9): 1200–1208. ISSN 2212-2672. doi:10.1016/j.jand.2013.05.001. 
  10. Misiakos EP, Macheras A, Kapetanakis T, Liakakos T (2007). "Short bowel syndrome: current medical and surgical trends". J. Clin. Gastroenterol. 41 (1): 5–18. PMID 17198059. doi:10.1097/01.mcg.0000212617.74337.e9. 
  11. Vanderhoof JA, Young RJ (2003). "Enteral and parenteral nutrition in the care of patients with short-bowel syndrome". Best Pract Res Clin Gastroenterol. 17 (6): 997–1015. PMID 14642862. 
  12. "File:ResectedIleum.jpg - Wikimedia Commons".  External link in |title= (help)
  13. "File:Crohn Jejunum.PNG - Wikimedia Commons". 

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