ABSTRACT
Transit Time...........................................................................................................117 Fecal Fat Test.........................................................................................................118 Measurement of the Stool Osmotic Gap...............................................................119 D-Xylose Absorption .............................................................................................119 Bile Salt Malabsorption.........................................................................................120 Lactose Malabsorption ..........................................................................................120 Small Bowel Bacterial Overgrowth.......................................................................120 Other Causes of Diarrhea That May Coexist with Enteric Failure......................121 Inflammation ..........................................................................................................123 Nutrient Balance Studies .......................................................................................123 Divalent Cation Balance and Metabolic Bone Disease ........................................124 Conclusion .............................................................................................................125 References..............................................................................................................125
One of the most difficult aspects of providing clinical advice and nutritional care for patients with intestinal failure (IF) is that the anatomy alone does not necessarily predict the actual function of the remaining bowel. This is most evident when there is a superimposed gastrointestinal disorder that aggravates digestion and absorption, such as Crohn’s disease or radiation enteritis or a mucosal disease that may be symptomatically silent, such as celiac disease. Finally, even with no increase in bowel length, patients with short bowel syndrome (SBS) may experience improvement in bowel function as adaptation occurs. Thus, a familiarity with measures of intestinal absorptive function is needed to optimally manage these patients, even though the methods used may require adjustment for patients with severe bowel disease.
