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)

Evaluation

Work-up

Evaluation

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

See Also

Gastric bypass surgery

External Links

References

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