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An Indispensable Parameters of Small Bowel Syndrome Include Etiology, Patho Physiology, Risk Factors, Inherited Syndromes

Muralinath E., Prapurnachandra Y., Ramesh Y., Pravithra V., Lalitha Ch., Babyshalini Ch., Venkatesh. B., Guru Prasad M.

Abstract


Small bowel cancer explains the following parameters such as malignancy, common sites, subtypes, symptoms, investigations, management and complications.

  • Small bowel malignancy: rare, ~1,900 cases/yr in UK; <5% of GI cancers despite comprising 90% of mucosal surface.
  • Common sites: duodenum (55-82%), jejunum (11-25%), ileum (7-17%). Risk factors,
  • Subtypes: adenocarcinoma (40%, duodenum, avg. age 66), neuroendocrine tumours (ileum), lymphoma (coeliac disease-related EATL), Kaposi sarcoma (HHV-8, immunocompromised).
  • Risk factors: Male, age, African ethnicity, celiac disease, Crohn's disease, FAP, and Lynch syndrome are non-modifiable; smoking, alcohol, obesity, poor fiber, and a diet heavy in red meat are modifiable.
  • Symptoms: non-specific abdominal pain, weight loss, occult/microscopic GI bleeding, anaemia; may cause gastric outlet or small bowel obstruction.
  • Investigations: FBC (anaemia), iron studies, LFTs (mets), stool FIT, genetic testing; imaging—CT, PET-CT, MRI enterography, capsule endoscopy, biopsy.
  • Management: Chemotherapy (5-FU, capecitabine, oxaliplatin), immunotherapy (pembrolizumab), radiation (palliative), surgical excision (segmental or Whipple's for duodenal tumors), and careful waiting (low-risk cases).
  • Complications: obstruction (gastric/small bowel), perforation, iron deficiency anaemia, nmetastasis (liver, lungs, bone, brain), death; prognosis—53% 5-year survival.

 


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References


Buchman, A. L. (2006). Etiology and initial management of short bowel syndrome. Gastroenterology, 130(2), S5-S15.

Lakkasani, S., Seth, D., Khokhar, I., Touza, M., & Dacosta, T. J. (2022). Concise review on short bowel syndrome: etiology, pathophysiology, and management. World Journal of Clinical Cases, 10(31), 11273.

Tappenden, K. A. (2014). Pathophysiology of short bowel syndrome: considerations of resected and residual anatomy. Journal of Parenteral and Enteral Nutrition, 38, 14S-22S.

Valla, D. C., & Condat, B. (2000). Portal vein thrombosis in adults: pathophysiology, pathogenesis and management. Journal of hepatology, 32(5), 865-871.

Navarro, F., Gleason, W. A., Rhoads, J. M., & Quiros-Tejeira, R. E. (2009). Short bowel syndrome: epidemiology, pathophysiology, and adaptation. Neoreviews, 10(7), e330-e338.

Goulet, O., Abi Nader, E., Pigneur, B., & Lambe, C. (2019). Short bowel syndrome as the leading cause of intestinal failure in early life: some insights into the management. Pediatric gastroenterology, hepatology & nutrition, 22(4), 303.

Gracey, M. (1979). The contaminated small bowel syndrome: pathogenesis, diagnosis, and treatment. The American Journal of Clinical Nutrition, 32(1), 234-243.

Seetharam, P., & Rodrigues, G. (2011). Short bowel syndrome: a review of management options. Saudi journal of gastroenterology: official journal of the Saudi Gastroenterology Association, 17(4), 229.

Drossman, D. A. (2016). Functional gastrointestinal disorders: history, pathophysiology, clinical features, and Rome IV. Gastroenterology, 150(6), 1262-1279.

Soares, R. L. (2014). Irritable bowel syndrome: a clinical review. World journal of gastroenterology: WJG, 20(34), 12144.

Lee, Y. J., & Park, K. S. (2014). Irritable bowel syndrome: emerging paradigm in pathophysiology. World journal of gastroenterology: WJG, 20(10), 2456.

Colitis-Pathophysiology, U. (2003). Inflammatory bowel disease part I: ulcerative colitis-pathophysiology and conventional and alternative treatment options. Altern Med Rev, 8(3), 247-83.

Cho, J. H., & Brant, S. R. (2011). Recent insights into the genetics of inflammatory bowel disease. Gastroenterology, 140(6), 1704-1712.

Ouahed, J., Spencer, E., Kotlarz, D., Shouval, D. S., Kowalik, M., Peng, K., ... & Snapper, S. B. (2020). Very early onset inflammatory bowel disease: a clinical approach with a focus on the role of genetics and underlying immune deficiencies. Inflammatory bowel diseases, 26(6), 820-842.

Chaparro, C. M., & Suchdev, P. S. (2019). Anemia epidemiology, pathophysiology, and etiology in low‐and middle‐income countries. Annals of the new York Academy of Sciences, 1450(1), 15-31.


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