BMJ Case Reports 2018; doi:10.1136/bcr-2018-224221
  • Rare disease

Metabolic acidosis in short bowel syndrome: think D-lactic acid acidosis

  1. Aminda De Silva2
  1. 1Department of Gastroenterology, Royal Berkshire NHS Foundation Trust, Reading, UK
  2. 2Department of Gastroenterology, Royal Berkshire Hospital, Reading, UK
  1. Correspondence to Dr Sorin Stanciu, stanciu.sor{at}
  • Accepted 30 April 2018
  • Published 16 May 2018


Short bowel syndrome (SBS) is a condition when a person’s gastrointestinal function is insufficient to supply the body with essential nutrients and hydration. Patients with SBS suffer from diarrhoea and symptoms of malabsorption such as weight loss, electrolyte disturbances and vitamin deficiencies. Long-term management of this condition can be complicated by the underlying disease, the abnormal bowel function and issues related to treatment like administration of parenteral nutrition and the use of a central venous catheter. Here, we describe a case of D-lactic acid acidosis, a rarer complication of SBS, presenting with generalised weakness and severe metabolic acidosis.


  • Contributors SS collected the data regarding this case report by searching the clinical notes and computerised health records, interpreted and analysed the data, compared it with available literature, conducted literature searches concerning the condition of D-lactic acidosis, its pathophysiology, clinical manifestations and treatment and wrote the article. ADS conceived the case report and made corrections to the first and second draft.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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