Summary
Definition
History and exam
Key diagnostic factors
- weight loss
- diarrhea
- volume depletion
- peripheral or presacral edema
Other diagnostic factors
- fatigue
- fractures
- postprandial epigastric or RUQ abdominal pain
- dysuria or renal colic
- abnormal neurologic examination
- jaundice and pruritus
- dermatologic signs
- night blindness
- motor weakness or altered gait
- proximal muscle weakness
- excessive bleeding
- confusion
Diagnostic investigations
1st investigations to order
- CBC
- serum electrolytes
- BUN and creatinine
- serum albumin
- serum calcium, zinc, selenium, folate
- vitamins A, B1, B2, B6, B12, C, D, and E
- methylmalonic acid (MMA)
- INR
Investigations to consider
- serum hepatic aminotransferases, alkaline phosphatase, and bilirubin (total and direct)
- urine analysis
- serum D-lactate
- fecal fat quantification
- upper GI contrast series
- DXA scan
- abdominal ultrasound
- CT abdomen
Treatment algorithm
Contributors
Authors VIEW ALL
Visiting Professor of Clinical Surgery and Medical Director of the Intestinal Transplant and Rehabilitation Center
University of Illinois at Chicago
Medical Director
Health Care Services Corporation
Chicago
IL
Disclosures
AB is an author of references cited in this topic.
Dr Alan Buchman would like to gratefully acknowledge Dr Michael Roth, a previous contributor to this topic. MR is an author of a reference cited in this topic.
Peer reviewers VIEW ALL
Associate Professor of Medicine
Division of Gastroenterology, Hepatology and Nutrition
Director
Vanderbilt Center for Human Nutrition
Vanderbilt University Medical Center
Nashville
TN
Disclosures
DS has been an advisor for B. Braun and Baxter Healthcare; has received lecture fees from Coram Healthcare, EMD Serono, and Nutrishare; has prepared a newsletter for Mayne Pharma; and has received research funding from Baxter Healthcare and NPS Pharmaceutical.
Hospital Dean
Intestinal Failure Unit
Hope Hospital
Salford
Manchester
UK
Disclosures
Not disclosed. JS is the author of references cited in this monograph.
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