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Related Concept Videos

Inflammatory Bowel Disease V: Surgical Management01:21

Inflammatory Bowel Disease V: Surgical Management

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Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
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Irritable Bowel Syndrome I: Introduction01:17

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Irritable Bowel Syndrome (IBS) is characterized by functional disturbances in the gastrointestinal system, presenting a cluster of symptoms without evident structural or biochemical abnormalities. It primarily affects the large intestine and may cause abdominal pain, bloating, excessive gas, diarrhea, constipation, or both.
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Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
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Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
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Related Experiment Video

Updated: Dec 3, 2025

Tissue Engineering of the Intestine in a Murine Model
08:45

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Unarousable child with a short bowel.

Luisa Cortellazzo Wiel1, Ester Conversano1, Giorgia Carlone2

  • 1Department of Medicine, Surgery, and Health Sciences, University of Trieste, Trieste, Italy.

Archives of Disease in Childhood. Education and Practice Edition
|October 30, 2020
PubMed
Summary

A child with short bowel syndrome experienced lethargy and metabolic acidosis after consuming apples. This case highlights a potential link between dietary intake and metabolic complications in pediatric short bowel syndrome patients.

Keywords:
Paediatric PracticeTherapeutics

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Area of Science:

  • Pediatric Gastroenterology
  • Metabolic Disorders
  • Short Bowel Syndrome

Background:

  • Short bowel syndrome (SBS) is a condition characterized by intestinal failure due to reduced absorptive surface area, often requiring specialized nutritional support.
  • Pediatric SBS can lead to various complications, including metabolic derangements, particularly after changes in feeding or parenteral nutrition weaning.
  • Apples, rich in fructose and sorbitol, can precipitate osmotic diarrhea and malabsorption in individuals with compromised intestinal function.

Observation:

  • A 4-year-old boy with SBS presented with acute lethargy and confusion.
  • Physical examination revealed metabolic acidosis with a high anion gap, despite normal lactate levels.
  • The patient had recently consumed a large quantity of apples, a known trigger for osmotic disturbances.

Findings:

  • Arterial blood gas analysis confirmed severe metabolic acidosis (pH 7.09, HCO3 5.8 mmol/L, BE -24) with an elevated anion gap (29.4).
  • Despite normal glucose and lactate levels, clinical presentation and history suggested a metabolic crisis.
  • Abdominal imaging ruled out surgical emergencies like intussusception, pointing towards a metabolic etiology.

Implications:

  • This case underscores the importance of considering dietary triggers, such as high-fructose or sorbitol intake, in the management of pediatric SBS.
  • Early recognition and management of metabolic acidosis in SBS patients are crucial to prevent neurological complications.
  • Further research into the specific dietary intolerances and metabolic pathways in SBS could optimize patient care and outcomes.