short bowel syndrome

WordNet

1. without possessing something at the time it is contractually sold; "he made his fortune by selling short just before the crash"
2. the location on a baseball field where the shortstop is stationed
3. low in stature; not tall; "he was short and stocky"; "short in stature"; "a short smokestack"; "a little man" (同)little
4. lacking foresight or scope; "a short view of the problem"; "shortsighted policies"; "shortsighted critics derided the plan"; "myopic thinking" (同)shortsighted, unforesightful, myopic
5. at a disadvantage; "I was caught short" (同)unawares
6. (primarily spatial sense) having little length or lacking in length; "short skirts"; "short hair"; "the board was a foot short"; "a short toss"
7. at some point or distance before a goal is reached; "he fell short of our expectations"
8. clean across; "the cars axle snapped short"
9. not holding securities or commodities that one sells in expectation of a fall in prices; "a short sale"; "short in cotton"
10. of speech sounds or syllables of relatively short duration; "the English vowel sounds in `pat, `pet, `pit, `pot, putt are short"
11. primarily temporal sense; indicating or being or seeming to be limited in duration; "a short life"; "a short flight"; "a short holiday"; "a short story"; "only a few short months"
12. so as to interrupt; "She took him up short before he could continue"
13. tending to crumble or break into flakes due to a large amount of shortening; "shortbread is a short crumbly cookie"; "a short flaky pie crust"
14. something curved in shape (同)arc
15. play on a string instrument with a bow
16. a knot with two loops and loose ends; used to tie shoelaces (同)bowknot
17. front part of a vessel or aircraft; "he pointed the bow of the boat toward the finish line" (同)fore, prow, stem
18. a decorative interlacing of ribbons
19. a slightly curved piece of resilient wood with taut horsehair strands; used in playing certain stringed instruments
20. a stroke with a curved piece of wood with taut horsehair strands that is used in playing stringed instruments
21. a weapon for shooting arrows, composed of a curved piece of resilient wood with a taut cord to propel the arrow
22. bending the head or body or knee as a sign of reverence or submission or shame or greeting (同)bowing, obeisance
23. an appearance by actors or performers at the end of the concert or play in order to acknowledge the applause of the audience (同)curtain_call
24. bend ones knee or body, or lower ones head; "He bowed before the King"; "She bowed her head in shame" (同)bow down
25. bend the head or the upper part of the body in a gesture of respect or greeting; "He bowed before the King"
26. a pattern of symptoms indicative of some disease
27. a complex of concurrent things; "every word has a syndrome of meanings"

PrepTutorEJDIC

1. (長さ・時間・距離などが)『短い』,近い・(人が)『背が低い』・(数量・期間などが)不足の』,乏しい;目標(標準)に達しない・(文などが)『簡潔な』,手短な・『そっけない』,ぞんぞいな,無愛想な・(ケーキなどが)かりかりする,さくさくする・(母音・音節が)短い;(詩の行の母音が)強勢のない・急に,突然・短いもの;欠けているもの・短篇映画(short movie, short subject) ・=short circuit・《複数形で》不足,欠損 / …‘を'短絡させる,ショートさせる / 短絡する,ショートする
2. 『弓』 / (楽器の)弓 / 弓形,弓形のもの(にじなど) / (リボンなどの)ちょう結び;ちょうネクタイ(bowtie) / (めがねの)つる / 〈バイオリンなど〉'を'弓でひく
3. (…に)『身をかがめる』,頭をさげる,おじぎをする《+『down』『to』+『名』》 / (…に)屈服する,従う《+『to』+『名』》 / 〈ひざ・腰〉'を'かがめる,(頭など)'を'さげる / …'を'曲げる / 〈感謝など〉'を'おじぎをして示す / …'を'身をかがめて案内する / おじぎ,えしゃく
4. 《時に複数形で;単数扱い》(ボート・船・飛行機の)『先端部』;へさき,機取 / ベートの最前部のオール;そのこぎ手
5. (疾患の徴候となる一群の)症徴候,症候群 / (事件・社会的状態などのパターンを示す)徴候形態
6. 〈C〉『腸』;《通例複数形で》腹わた,内臓 / 《複数形で》内部,中心部
7. 半ズボン,ショートパンツ / 《おもに米》(男物下着の)パンツ

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/01/05 16:51:31」(JST)

wiki en

[Wiki en表示]

Short bowel syndrome
Resected diseased ileum.
Classification and external resources
Specialty	gastroenterology
ICD-10	K91.2
ICD-9-CM	579.3
DiseasesDB	12026
MedlinePlus	000237
eMedicine	med/2746 ped/2088
MeSH	D012778

Short bowel syndrome (SBS, also short gut syndrome or simply short gut) is a malabsorption disorder caused by the surgical removal of the small intestine, or rarely due to the complete dysfunction of a large segment of bowel. Most cases are acquired, although some children are born with a congenital short bowel. It usually does not develop unless more than two thirds of the small intestine have been removed. SBS has been designated a rare disease by the EMA, and is eligible for orphan drug designation according to the U.S. Food and Drug Administration (FDA). There are roughly 3,500 adults and 9,000 children with SBS in the USA alone.

Signs and symptoms

The symptoms of short bowel syndrome can include:

• Abdominal pain
• Diarrhea and steatorrhea (oily or sticky stool, which can be malodorous)
• Fluid depletion
• Weight loss and malnutrition
• Fatigue

Patients with short bowel syndrome may have complications caused by malabsorption of vitamins and minerals, such as deficiencies in vitamins A, D, E, K, B₉ (folic acid), and B₁₂, calcium, magnesium, iron, and zinc. These may appear as anemia, hyperkeratosis (scaling of the skin), easy bruising, muscle spasms, poor blood clotting, and bone pain.

Causes

Short bowel syndrome in adults and children is usually caused by surgery for:

• Crohn's disease, an inflammatory disorder of the digestive tract
• Volvulus, a spontaneous twisting of the small intestine that cuts off the blood supply and leads to tissue death
• Tumors of the small intestine
• Injury or trauma to the small intestine
• Necrotizing enterocolitis (premature newborn)
• Bypass surgery to treat obesity
• Surgery to remove diseases or damaged portion of the small intestine

Pathophysiology

In healthy adults, the small intestine has an average length of approximately 6 meters (19.7 feet). Short bowel syndrome usually develops when there is less than 2 meters (6.6 feet) of the small intestine left to absorb sufficient nutrients.

Short bowel syndrome caused by the surgical removal of a portion of the bowel may be a temporary condition, due to the adaptive property of the small intestine.

In a process called intestinal adaptation, physiological changes to the remaining portion of the small intestine occur to increase its absorptive capacity. These changes include:

• Enlargement and lengthening of the villi found in the lining
• Increase in the diameter of the small intestine
• Slow down in peristalsis or movement of food through the small intestine

Treatments

Symptoms of short bowel syndrome are usually addressed with medication. These include:

• Anti-diarrheal medicine (e.g. loperamide, codeine)
• Vitamin, mineral supplements and L-glutamine powder mixed with water
• H2 blocker and proton pump inhibitors to reduce stomach acid
• Lactase supplement (to improve the bloating and diarrhoea associated with lactose intolerance)

In 2004, the USFDA approved a therapy that reduces the frequency and volume of total parenteral nutrition (TPN), comprising: NutreStore (oral solution of glutamine) and Zorbtive (growth hormone, of recombinant DNA origin, for injection) together with a specialized oral diet. In 2012, an advisory panel to the USFDA voted unanimously to approve for treatment of SBS the agent teduglutide, a glucagon-like peptide-2 analog developed by NPS Pharmaceuticals, who intend to market the agent in the United States under the brandname Gattex. Teduglutide had been previously approved for use in Europe and is marketed under the brand Revestive by Nycomed.

Surgical procedures to lengthen dilated bowel include the Bianchi procedure, where the bowel is cut in half and one end is sewn to the other, and a newer procedure called serial transverse enteroplasty (STEP), where the bowel is cut and stapled in a zigzag pattern. Heung Bae Kim, MD, and Tom Jaksic, MD, both of Children's Hospital Boston, devised the STEP procedure in the early 2000s. The procedure lengthens the bowel of children with SBS and may allow children to avoid the need for intestinal transplantation. As of June 2009, Kim and Jaksic have performed 18 STEP procedures. The Bianchi and STEP procedures are usually performed by pediatric surgeons at quaternary hospitals who specialize in small bowel surgery.

Prognosis

There is no cure for short bowel syndrome except transplant. In newborn infants, the 4-year survival rate on parenteral nutrition is approximately 70%. In newborn infants with less than 10% of expected intestinal length, 5 year survival is approximately 20%. Some studies suggest that much of the mortality is due to a complication of the total parenteral nutrition (TPN), especially chronic liver disease. Much hope is vested in Omegaven, a type of lipid TPN feed, in which recent case reports suggest the risk of liver disease is much lower.

Although promising, small intestine transplant has a mixed success rate, with postoperative mortality rate of up to 30%. One-year and 4-year survival rate are 90% and 60%, respectively.

References

External links

• Short Bowel Syndrome, from Children's Hospital Boston
• About Short Bowel Syndrome, from Children's Hospital Boston
• The Center for Advanced Intestinal Rehabilitation at Children's Hospital Boston
• Better Health Channel - Short Bowel Syndrome
• Health In Plain English - Short Bowel Syndrome
• National Digestive Diseases Information Clearinghouse - Short Bowel Syndrome

UpToDate Contents

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• 1. 成人における短腸症候群のマネージメント management of the short bowel syndrome in adults
• 2. 短腸症候群の病態生理 pathophysiology of the short bowel syndrome
• 3. 小児における短腸症候群のマネージメント management of the short bowel syndrome in children
• 4. 成人における短腸症候群の慢性合併症 chronic complications of the short bowel syndrome in adults
• 5. 小児における短腸症候群の慢性合併症 chronic complications of the short bowel syndrome in children

English Journal

• Elasticity and geometry: a computational model of the Heineke-Mikulicz strictureplasty.

• Tsamis A1, Pocivavsek L, Vorp DA.
• Biomechanics and modeling in mechanobiology.Biomech Model Mechanobiol.2014 Nov;13(6):1185-98. doi: 10.1007/s10237-014-0565-9. Epub 2014 Mar 27.
• Crohn's disease is a challenging inflammatory process with a propensity for focal gastro-intestinal tract inflammation and stricture. Surgically, Crohn's is often treated with resection. However, a subtype of diffuse disease with multiple strictures is treated by strictureplasty procedures in hope o
• PMID 24671519

• Scaffolding for challenging environments: Materials selection for tissue engineered intestine.

• Boomer L1, Liu Y, Mahler N, Johnson J, Zak K, Nelson T, Lannutti J, Besner GE.
• Journal of biomedical materials research. Part A.J Biomed Mater Res A.2014 Nov;102(11):3795-802. doi: 10.1002/jbm.a.35047. Epub 2013 Dec 12.
• Novel therapies are crucially needed for short bowel syndrome. One potential therapy is the production of tissue engineered intestine (TEI). The intestinal environment presents significant challenges to the selection of appropriate material for tissue engineering scaffolds. Our goal was to character
• PMID 24288210

Japanese Journal

• 症例報告 長期HPN管理短腸症候群の1例 : 成人小腸移植適応患者の現状

• 橋詰 直樹,飯沼 泰史,新田 幸壽 [他]
• 日本小児外科学会雑誌 48(4), 743-748, 2012-06
• NAID 40019370294

• 完全静脈栄養管理中に心不全を呈し,カルニチン・セレン投与にて改善した1例

• 照井 慶太,小松 秀吾,篠塚 俊介,平本 龍吾
• 日本小児外科学会雑誌 47(7), 1026-1032, 2011-12-20
• 14歳男児.急性虫垂炎・多臓器不全に対し虫垂切除を施行.術後,多発性消化管穿孔に対しトライツ靭帯から20・80cmの小腸に2箇所の腸瘻を造設し,完全静脈栄養で管理した.周術期には47日間の透析を要した.第87病日,心不全(駆出率37%)を認めたが,精査にて明らかな原因を見出せず,微量栄養素欠乏が除外診断として残った.亜セレン酸Na静脈内投与及び,腸瘻間の60cmの空腸を用いてL-カルニチン投与を開 …
• NAID 110008896723

Related Links

• Short Bowel Syndrome - National Institute of Diabetes and ...

Reviews short bowel syndrome, a disorder that typically occurs in people who had half or more of their small intestine removed. Discusses causes, signs and symptoms, and treatment options. ... What is short bowel ...

• About Short Bowel Syndrome | ShortBowelSupport.com

Learn about Short Bowel Syndrome or Short Gut Syndrome including treatment options and lifestyle tips, as well as get support from the SBS community. ... Your Resource for Short Bowel Syndrome We're here to help patients ...

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★リンクテーブル★

リンク元	「短腸症候群」
関連記事	「short」「bow」「syndrome」

「短腸症候群」

　　[★]

英

short-gut syndrome, short bowel syndrome, short-bowel syndrome

同

短小腸症候群

関

吸収不良症候群

[show details]

短腸症候群 : 約 29,300 件
短小腸症候群 : 約 46 件

• 腸管の壊死をきたすような疾患などにより腸管を50-60%切除した後に生じる消化不良症候群。
• 例えば、急性上腸間膜動脈閉塞、絞扼性腸閉塞(SSUR.473,557)。成人では外傷、Crohn病、腸間膜動脈血栓症/腸間膜静脈血栓症、小児では、新生児壊死性腸炎、小腸閉鎖症、腸捻転などがある(SSUR.202)。
• 症状：胃酸過多、ビタミンB12吸収不全、胆汁吸収不全
• 治療：経腸栄養法/経静脈栄養法が必要となる場合がある。

「short」

　　[★]

• adj.

• (比較級shorter-最上級shortest)短い、不足した、乏しい、省略された

関

abbreviated、brevis、brief、dearth、deficit、in short、insufficiency、insufficient、lack、paucity、poor、scant、scanty、scarce、scarcity、shortage、shortness

　 　 　 　 　 　 　 　 　 　 　 　 　 　

「bow」

　　[★] 　 　 　 　 　 　 　 　 　 　 　 　 　 　 　

「syndrome」

　　[★]

• n.

• 症候群