| 特集名 | 腸管と骨・ミネラル代謝 | |
|---|---|---|
| 題名 | 臨床 (3) 短腸症候群と骨・ミネラル代謝 | |
| 発刊年月 | 2010年 04月 | |
| 著者 | 大野 洋介 | 防衛医科大学校内科3・内分泌代謝内科 |
| 著者 | 田中 祐司 | 防衛医科大学校内科3・内分泌代謝内科 |
| 【 要旨 】 | 短腸症候群は，小腸の広範囲切除後に消化・吸収機能の低下を背景として重度の下痢と栄養障害をきたす病態で，おもに外科領域において問題とされるが，吸収障害がMg・ビタミンDに及ぶと，骨・ミネラル（Ca/P）代謝に重大かつ特徴的な障害をきたす． Ca/P/Mg/ビタミンD代謝調節機構や消化管の病態生理を理解した分析と長期的管理が必要である． | |
| Theme | Intestinal tract and bone mineral metabolism | |
|---|---|---|
| Title | Pathophysiology of electrolyte disorders in short bowel syndrome | |
| Author | Yosuke Ono | Division of Endocrinology and Metabolism, Department of Medicine, National Defense Medical College |
| Author | Yuji Tanaka | Division of Endocrinology and Metabolism, Department of Medicine, National Defense Medical College |
| [ Summary ] | Short bowel syndrome is defined as a condition related to malabsorption and malnutrition resulting from the loss of absorptive area after massive small bowel resection. The metabolic complications after small bowel resection depend on a number of factors, including the extent and site of intestinal resection, presence or absence of the ileocecal valve and functional capacity of the remaining small intestine and colon. The severity of clinical features varies from patient to patient. Hypomagnesemia is common and is treated with oral or intravenous magnesium supplements. Magnesium deficiency occurs due to reduced absorption because of chelation with unabsorbed fatty acids in the bowel lumen and because of increased renal excretion. Insufficient PTH secretion and its effects on bone and the kidnies due to hypomagnesemia results in hypocalcemia. Patients need long-term frequent nutritional monitoring and care to prevent disorders associated with malabsorption. |
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