LONG TERM NUTRITIONAL EFFECTS OF EXTENSIVE RESECTION OF THE SMALL INTESTINE

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Abstract
A nutritional study was carried out on 36 patients several years after major resection of the small intestine (100-330 cm). Thirty-one of these resections were performed for Crohn''s disease and only patients who had been clinically free of disease for > 1 yr were studied. The group of patients were 15% below their ideal weight. Total body fat was 24% below the predicted normal value and total body protein was 10% below. Although deficiencies of Fe, vitamin B12 and folic acid were frequently found, only 6 patients were anemic. Other vitamin and mineral deficiencies were common. Despite these abnormalities, 2/3 of the patients were engaged in their normal occupation full-time and were subjectively well. The others who did not regain their normal capacity for work, had a greater nutritional deficit and a shorter length of remaining small intestine. Nutritional deficiencies are common following extensive small bowel resection and all patients need regular follow-up and appropriate vitamin and mineral supplementation. However, major disturbances of body composition and severe protein energy malnutrition with a reduced capacity for work are restricted to a small number of patients with very short lengths of remaining small intestine.