ABSTRACT
Physiological Considerations...................................................................................26 Stomach........................................................................................................26 Small Bowel.................................................................................................26 Colon............................................................................................................27 Unique Functions of the Ileum ...................................................................29
Effects of Intestinal Resection.................................................................................29 Gastric and Intestinal Secretion and Motility .............................................29 Absorption of Fluid and Electrolytes..........................................................29 Absorption of Nutrients...............................................................................30
Adaptation of the Intestine ......................................................................................30 Effect of Excluding Food from the Bowel Lumen.....................................31 Factors Influencing Bowel Atrophy ............................................................31 Does Bowel Rest Induce Gut Atrophy in Man?.........................................31
Implications for Management of Short Bowel Syndrome......................................32 Jejunal Resection with Intact Ileum and Colon..........................................32 Ileal Resection of Less than 100 cm with Colon Largely Intact ...............32 Ileal Resection of More than 100 to 200 cm with Colon Largely Intact...............................................................................................32 Resection in Excess of 200 cm of Small Bowel and Lesser Resection with Associated Colectomy ........................................................32 Resection Leaving Less than 60 cm Small Bowel or Only Duodenum: Massive Bowel Resection........................................................32
Practical Considerations ..........................................................................................33 Control of Diarrhea .....................................................................................33 Intravenous Fluids........................................................................................33 Oral Feeding ................................................................................................33 Parenteral Nutrition .....................................................................................34
Summary ..................................................................................................................35 References................................................................................................................35
