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

BMJ Case Rep. 2018 May 16:2018:bcr2018224221. doi: 10.1136/bcr-2018-224221.

Abstract

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.

Keywords: malabsorption; metabolic disorders; nutritional support.

Publication types

  • Case Reports

MeSH terms

  • Acidosis, Lactic / blood
  • Acidosis, Lactic / drug therapy
  • Acidosis, Lactic / etiology*
  • Aged
  • Anti-Infective Agents / administration & dosage
  • C-Reactive Protein / analysis
  • Humans
  • Lactic Acid / biosynthesis
  • Male
  • Parenteral Nutrition, Home / adverse effects
  • Rifamycins / administration & dosage
  • Rifaximin
  • Short Bowel Syndrome / complications*
  • Sodium Bicarbonate / therapeutic use

Substances

  • Anti-Infective Agents
  • Rifamycins
  • Lactic Acid
  • Sodium Bicarbonate
  • C-Reactive Protein
  • Rifaximin