Short bowel syndrome

Background

• Well-recognized complication of gastric bypass
• Rapid post-prandial gastric emptying, release of gastric hormones, splanchnic vasodilation
• Hyperinsulinemic and hypoglycemic state

Clinical Features

• Nausea, vomiting, bloating, abdominal cramps, diarrhea, diaphoresis
  • Early dumping= symptoms 30-60min after a meal
  • Late dumping= symptoms 1-3 hours after a meal

Differential Diagnosis

Abdominal Pain Differential (Comprehensive)

Diagnosis

Work-up

• Same as Abdominal Pain
• Diagnosis of exclusion

Management

• Dietary Modifications
  • Avoid highly concentrated foods
  • Separate eating and drinking
• Octreotide
  • Positive case reports

Disposition

• Home if other diagnoses excluded and able to tolerate oral intake

References

O'Brien M. Acute Abdominal Pain In: Tintinalli's Emergency Medicine. 7th ed. McGraw-Hill. 2011:Chapter 74