Management of patients with a short bowel

Table 4 Summary of the problems of a short bowel

	Jejunum-colon	Jejunostomy
Presentation	gradual, diarrhoea and undernutrition	acute fluid losses
Water, sodium and	uncommon in the	common
magnesium depletion	long-term
Nutrient malabsorption	common*	very common
D(-)lactic acidosis	occasionally	none
Renal stones (calcium oxalate)	25%	none
Gallstones (pigment)	45%	45%
Adaptation	functional adaptation	no evidence
Social problems	diarrhoea dehydration dependency on treatment	high stomal output

^*: bacterial fermentation of carbohydrate salvages some energy, but D (-) lactic acidosis can occur if the diet is high in mono and oligosaccharides.