ABSTRACT
Normal Intraluminal Digestion .............................................................................162 Digestion and Absorption of Protein.........................................................162 Digestion and Absorption of Fats .............................................................164
Intestinal Resection................................................................................................166 Mechanisms of Malabsorption ..................................................................166 Pancreatic Dysfunction in Intestinal Resection ........................................167 Bile-Salt Dysfunction after Intestinal Resection.......................................168
Bile Acid Therapy..................................................................................................168 Pancreatic Enzyme Supplementation ....................................................................170 Conclusion .............................................................................................................172 References..............................................................................................................172
Intestinal resection has multiple adverse effects on digestion. Though the primary digestive defect is decreased absorptive surface area, a plethora of other physiologic changes occur, including rapid gastric emptying, decreased small intestinal transit time, gastric acid hypersecretion, bacterial overgrowth, and bile salt depletion.1 Each of these individual factors may adversely affect either the breakdown or uptake of nutrients across the small intestinal mucosa. While awaiting the process of intestinal adaptation, management of short bowel syndrome involves parenteral nutrition, dietary changes, and medications that modify the individual pathophysiologic mechanisms. Bile acid therapy and pancreatic enzymes are among the specific therapies that address the maldigestive processes occurring after intestinal resection.
