Case 18.3

Short bowel syndrome is a rare disease, and the overall incidence in the population is unknown but estimated at 10-15,000 persons in the United States, with an average age of onset in adults at age 52, and a slight female predominance (52-57%).  The most common disorders in adults underlying the development of SBS and subsequent IF are Crohn’s Disease, mesenteric ischemia, abdominal trauma, motility disorder, malignancy, intestinal volvulus, and radiation enteritis.  Patients with SBS carry a poor prognosis, with studies showing 50% mortality at 10 years.

Identify the correct pairings for where key nutrients are absorbed along the intestinal tract as well as where key hormonal mediators of nutrient processing are produced in the intestinal tract:
Iron -> jejunum
Folate -> duodenum
Lactose -> jejunum/proximal ileum
Fats, sugars, amino acids -> Duodenum and jejunum/proximal ileum
Bile salts -> distal ileum
B12 -> distal ileum
Calcium -> distal ileum
Water soluble vitamins -> duodenum and jejunum/proximal ileum
Gastrin -> stomach
Peptide YY -> duodenum
Glucagon-like peptide (GLP) 1 -> duodenum
Glucagon-like peptide (GLP) 2 -> distal ileum/colon