Short bowel syndrome

Question 1

What is the primary aim of managing short bowel syndrome (SBS)?

Answer 1

To ensure adequate nutrition and drug absorption, reducing the risk of complications.

Question 2

Which vitamin and mineral deficiencies are common in SBS?

Answer 2

Vitamins A, B12, D, E, K, essential fatty acids, zinc, selenium, and magnesium.

Question 3

Why is oral magnesium supplementation challenging in SBS?

Answer 3

It may cause diarrhoea; intravenous magnesium may be needed instead.

Question 4

Which antimotility agent is preferred in SBS and why?

Answer 4

Loperamide – it’s not sedating, doesn’t cause dependence, and avoids fat malabsorption.

Question 5

When might codeine be added in SBS treatment?

Answer 5

If loperamide alone does not sufficiently reduce diarrhoea.

Question 6

Which drug reduces gastric acid secretion and may lower jejunostomy output?

Answer 6

Omeprazole (a proton pump inhibitor).

Question 7

What types of oral dosage forms should be avoided in SBS?

Answer 7

Enteric-coated and modified-release formulations.

Question 8

Name four drugs that may need higher doses or IV forms due to poor absorption in SBS.

Answer 8

Levothyroxine, warfarin, digoxin, and oral contraceptives.