Short Bowel Syndrome: A Case Study of Multiple Micronutrient Deficiencies and High Ileostomy Output

Dixit D1*, Rodriguez VI2, Ruiz NC3 and Kamel AY4

1Department of Internal Medicine, University of Florida, USA
2College of Medicine, University of Florida, USA
3Division of Digestive Diseases, Emory University, USA
4Department of Pharmacy, University of Florida Health Shands Hospital, USA

^*Correspondance to: Devika Dixit 

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Abstract:

Short bowel syndrome is a malabsorptive disorder of congenital or surgical etiology defined by less than 200 cm of small bowel in situ. Short bowel syndrome can result in the inability to maintain nutrition, hydration, electrolytes, and micronutrients. Significant micronutrient deficiencies can occur, which can exacerbate without regular monitoring and repletion. Malnutrition and nutritional deficiencies in short bowel syndrome are well documented yet published case studies are lacking. We describe a woman in her 50s with a history of Crohn’s disease, complicated by multiple surgeries that resulted in short bowel syndrome. She presented with abdominal pain, poor oral intake and tolerance, weight loss, nausea, vomiting, dehydration, and excessive ileostomy output with clinical signs and symptoms suggestive of micronutrient deficiencies. She was found to have the following deficiencies: thiamine, pyridoxine, 25-hydroxyvitamin D, and borderline deficiencies in copper and zinc, which were all aggressively repleted. Her output continued to be high, necessitating the use of octreotide. At her six-month follow-up visit, her ileostomy output had stabilized, and all monitored micronutrient levels were within reference range; 25-hydroxyvitamin D level was within reference range at eighteen months. This case highlights the need for management of ileostomy output and active micronutrient surveillance and repletion in patients with short bowel syndrome and high output.

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Cite the Article:

Dixit D, Rodriguez VI, Ruiz NC, Kamel AY. Short Bowel Syndrome: A Case Study of Multiple Micronutrient Deficiencies and High Ileostomy Output. Ann Clin Case Rep. 2023; 8: 2425.