Medical Nutrition Therapy for Lower GI Diseases Explained
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65 cards
Question: What amount of small bowel remaining typically defines Short Bowel Syndrome (SBS) when the colon is absent versus when the colon is present?
Answer: SBS is defined as about 100–120 cm of small bowel without a colon, or about 50 cm of small bowel if the colon remains.
Question: What percentage of small bowel loss usually results in Short Bowel Syndrome?
Answer: A loss of about 70–75% of the small bowel usually results in SBS.
Question: How well is jejunal resection tolerated when less than 75% is removed?
Answer: Jejunal resection of less than 75% is usually well tolerated.
Question: What minimal amount of jejunum can be resected and still be usually well tolerated if the ileum and colon are intact?
Answer: A minimum of 60 cm of jejunum resection is usually well tolerated when the ileum and entire colon are intact.
Question: What clinical problems are associated with more severe resections leaving less than 100 cm of small bowel without the colon?
Answer: Severe malabsorption occurs with residual small bowel under 100 cm without the colon in continuity.
Question: Why does an end jejunostomy often lead to severe fluid and electrolyte loss and need for home parenteral nutrition?
Answer: End jejunostomy indicates the ileum and colon are resected, causing large fluid and electrolyte losses that often require home parenteral nutrition.
Question: After jejunal resection with an intact ileum and colon, how does the ileum respond?
Answer: The ileum takes over many jejunal functions and patients adapt faster to a normal diet.
Question: How does reduced small bowel surface area after jejunal resection affect nutrient absorption?
Answer: Reduced surface area lowers absorption capacity for micronutrients and reduces absorption of excess sugars (especially lactose) and lipids.
Question: What initial medical nutrition therapy (MNT) is recommended after jejunal resection?
Answer: PN or distal enteral nutrition (semi‑elemental) for 2–3 days, then progression to oral diet.
Question: When advancing to oral diet after jejunal resection, what macronutrient balance and meal pattern are recommended?
Answer: A normal balance of carbohydrate, protein, and fat with six small feedings per day.