Problems in Management

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CONSEQUENCES OF ILEAL DYSFUNCTION: AN APPROACH TO MANAGEMENT

Richard B. Sewell F.R.A.C.P.

Gastroenterology Unit, Austin Hospital, Melbourne

Formerly Gastroenterology Fellow, now Research Fellow, Liver Unit, Kings College Hospital, London.Search for more papers by this author

Neville E. Hoffman M.D., Ph.D., M.R.A.C.P.,

Neville E. Hoffman M.D., Ph.D., M.R.A.C.P.

Gastroenterology Unit, Austin Hospital, Melbourne

Formerly Second Assistant, Department of Medicine, now Assistant Professor, Department of Medicine, Gastroenterology Division, University of Texas, Houston, U.S.A.Search for more papers by this author

Richard A. Smallwood M.D., F.R.A.C.P.,

Corresponding Author

Richard A. Smallwood M.D., F.R.A.C.P.

n/[email protected]

Gastroenterology Unit, Austin Hospital, Melbourne

Director of Gastroenterology.

Address for reprints: Dr R. A. Smallwood, Director of Gastroenterology, Austin Hospital, Heidelberg, Vic. 3084.

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Richard B. Sewell F.R.A.C.P.,

Richard B. Sewell F.R.A.C.P.

Gastroenterology Unit, Austin Hospital, Melbourne

Formerly Gastroenterology Fellow, now Research Fellow, Liver Unit, Kings College Hospital, London.Search for more papers by this author

Neville E. Hoffman M.D., Ph.D., M.R.A.C.P.,

Neville E. Hoffman M.D., Ph.D., M.R.A.C.P.

Gastroenterology Unit, Austin Hospital, Melbourne

Richard A. Smallwood M.D., F.R.A.C.P.,

Corresponding Author

Richard A. Smallwood M.D., F.R.A.C.P.

n/[email protected]

Gastroenterology Unit, Austin Hospital, Melbourne

Director of Gastroenterology.

Address for reprints: Dr R. A. Smallwood, Director of Gastroenterology, Austin Hospital, Heidelberg, Vic. 3084.

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First published: 01 December 1978

https://doi.org/10.5694/j.1326-5377.1978.tb131769.x

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Abstract

Fourteen patients with ileal dysfunction due to resection or bypass were encountered over an 18-month period. Symptoms had been present for a mean period of 1.8 years. Diarrhoea was a universal symptom, and varied from mild to incapacitating. Weight loss, due in part to malabsorption and in part to the patients' fear of eating, occurred in 10 of 14 patients. The chief metabolic abnormalities were steatorrhoea and hypokalemia. Vitamin B₁₂ deficiency, folate deficiency, anaemia, hypoalbuminaemia, hypocalcaemia, hypomagnesaemia, hyperoxaluria, and an abnormal prothrombin ratio were less frequently seen. Treatment with cholestyramine and/or long-chain fat restriction effectively reduced diarrhoea in every case, and this was supplemented by replacement of specific deficiencies. There was little added benefit from non-specific antidiarrhoeal agents. It was found that the major symptoms of ileal dysfunction are readily treated, but that attention should also be given to a number of nutritional deficiencies.

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Volume2, Issue13

December 1978

Pages 598-601

CONSEQUENCES OF ILEAL DYSFUNCTION: AN APPROACH TO MANAGEMENT

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CONSEQUENCES OF ILEAL DYSFUNCTION: AN APPROACH TO MANAGEMENT

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