Encephalopathy in short bowel syndrome: a diagnostic challenge.

Data de publicació: 01/01/2023 Data Ahead of Print: 15/06/2022

Autors de IIS La Fe

• Gorka Martinez Navarro

  Autor

• Begoña Polo Miquel

  Autor

• Esther Donat Aliaga

  Autor

• Etna Masip Simó

  Autor

• 

  Carmen Ribes Koninckx

  Autor

Autors aliens a IIS La Fe

• Pacheco J
• Adell A
• Ortega P

Grups d'Investigació

• Enfermedad celíaca e Inmunopatología digestiva

  

  Investigador Principal

  Carmen Ribes Koninckx

• Unidad Mixta De Investigación en Nutrición de Precisión para patologías digestivas (NUTRICURA PDig)

  

  Investigador Principal

  Carmen Ribes Koninckx

Abstract

A 15-year-old boy was admitted to the hospital due to ataxia, drowsiness and bradypsychia. He was known to have a short bowel syndrome Initial venous blood gases revealed a metabolic acidosis with a high anion gap of 24 mmol/L and normal L-lactate. He improved with fasting and fluids and was discharged with oral metronidazole. 2 weeks later he was admitted again with similar symptoms. A specific study of D-Lactic acidosis was carried out, confirming the diagnosis. D-lactic acidosis is an uncommon complication of short bowel syndrome. It occurs as a consequence of the metabolism of unabsorbed carbohydrates. The symptoms are mainly neurological. Limiting the dietary carbohydrates is useful to avoid recurrences. Poorly absorbable antibiotics are used but with varying results. Surgery may be an option if medical treatment fails. Probiotics might be useful to avoid symthoms recurrence.

Keywords

• Short bowel syndrome; Lactic acidosis; Microbiota; Probiotics