SHORT BOWEL SYNDROME

 






Most important metabolic consequences of short bowel syndrome:
  1. Sodium and fluid depletion
  2. Hypocalcemia
  3. Hypomagnesemia
  4. Normal anion gap metabolic acidosis (GI bicarbonate losses)
  5. Elevated anion gap metabolic acidosis (D-lactic acidosis -- see below)
  6. Hyperoxaluria




Take-home point: D lactic acidosis remains an underdiagnosed complication of short bowel syndrome. It presents as brain fogs and bloating after a carb meal. Keep D lactic acidosis in mind when dealing with HAGMA and normal "routine" lactic acid levels in those pts.

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