Our Summary

This research looked at how much of a pig’s intestine needs to be removed to cause short-bowel syndrome (SBS), a condition where the body is unable to absorb enough nutrients from the food. The researchers removed either 75%, 90%, or 100% of the middle part of the intestine in different groups of pigs. They then observed things like the pigs’ weight, stool consistency, and various blood tests, as well as how well the remaining intestine could absorb a sugar called D-xylose, and measured the length of the intestinal villi, which are small finger-like projections that help with absorption.

They found that only the pigs that had 100% of their intestine removed had continuous weight loss, diarrhea, and decreased levels of certain proteins in their blood, indicating severe malnutrition. The other groups did not show these symptoms. The level of a certain amino acid, citrulline, was different in each group, suggesting it may be a useful marker for the extent of intestinal damage. The ability to absorb D-xylose was lowest in the 100% group and highest in the 75% group. The length of the intestinal villi decreased in all groups, but was highest in the 75% group.

In conclusion, removing 75% of the intestine might not be a good model for SBS because the pigs seemed to recover quite well. The 90% model could be good for longer-term studies because the pigs might survive longer due to the remaining intestine partially compensating for the loss. The 100% model is only suitable for short-term studies, or those that are immediately followed by a small intestine transplant, because of the severe nutritional problems it causes.

FAQs

  1. What percentage of intestinal removal in pigs was found to cause severe malnutrition and continuous weight loss?
  2. What amino acid’s level was found to be different in each group and could potentially serve as a marker for the extent of intestinal damage?
  3. What ability was highest in the 75% group and lowest in the 100% group among the pigs?

Doctor’s Tip

Therefore, a helpful tip a doctor might give a patient undergoing intestinal resection is to discuss with them the extent of the resection and potential implications for their nutritional status. It is important to monitor for symptoms of malnutrition, such as weight loss, diarrhea, and changes in blood protein levels. Additionally, regular blood tests and monitoring of absorption markers, such as D-xylose and citrulline, can help assess the functionality of the remaining intestine. Patients should also be aware of the potential need for nutritional support or interventions post-surgery to ensure adequate nutrient absorption and overall health.

Suitable For

Patients who may be recommended for intestinal resection include those with conditions such as Crohn’s disease, intestinal obstruction, tumors, or injuries to the intestine. Intestinal resection may be necessary if a portion of the intestine is damaged or diseased and is not functioning properly. In cases where a significant portion of the intestine needs to be removed, patients may be at risk for developing short-bowel syndrome, which can lead to malnutrition and other complications. It is important for healthcare providers to carefully assess each individual case and determine the most appropriate course of treatment based on the specific circumstances of the patient.

Timeline

Before intestinal resection:

  1. Patient undergoes diagnostic tests to determine the need for surgery, such as imaging scans or endoscopy.
  2. Patient may undergo bowel preparation to clean out the intestines before surgery.
  3. Patient meets with the surgical team to discuss the procedure and potential risks and benefits.
  4. Surgery is performed to remove the diseased or damaged part of the intestine.

After intestinal resection:

  1. Patient is monitored closely in the hospital for signs of complications, such as infection or leakage from the surgical site.
  2. Patient is started on a liquid diet and gradually progresses to solid foods as tolerated.
  3. Patient may need to take medications to manage pain or prevent infection.
  4. Patient may require follow-up appointments with their healthcare team to monitor their recovery and adjust their treatment plan as needed.
  5. Patient may need to make dietary and lifestyle changes to adapt to the changes in their digestive system.
  6. Patient may need to undergo additional treatments or therapies to manage any long-term effects of the intestinal resection, such as nutritional deficiencies or bowel function issues.

What to Ask Your Doctor

Some questions a patient should ask their doctor about intestinal resection include:

  1. What percentage of my intestine will be removed during the surgery?
  2. What are the potential short-term and long-term effects of removing a certain percentage of my intestine?
  3. How will the remaining intestine compensate for the loss of the removed portion?
  4. What nutritional changes or dietary adjustments will I need to make after the surgery?
  5. How will my ability to absorb nutrients be affected after the surgery?
  6. What tests or markers will be used to monitor my nutritional status post-surgery?
  7. Will I need any additional treatments or interventions to manage any potential complications, such as short-bowel syndrome?
  8. What are the risks and benefits of undergoing an intestinal resection procedure?
  9. How long is the recovery process expected to be, and what can I expect during that time?
  10. Are there any alternative treatment options or approaches that could be considered instead of or in addition to intestinal resection?

Reference

Authors: Frongia G, Nickkholgh A, Hafezi M MR, Arvin J, Saffari A, Golriz M, Aydin E, Weih S, Kessler M, Emami G, Garoussi C, Okun JG, Schmidt K, Thiel C, Brune M, Günther P, Holland-Cunz S, Mehrabi A. Journal: J Invest Surg. 2016;29(1):57-65. doi: 10.3109/08941939.2015.1057304. Epub 2015 Sep 16. PMID: 26375577