Article Text

Download PDFPDF
D-lactic acidosis presenting as metabolic encephalopathy in a patient with short bowel syndrome
  1. Ciarán McHale,
  2. Eoin Keating,
  3. Helen O'Donovan and
  4. Eoin Slattery
  1. Department of Gastroenterology, Galway University Hospital, Galway, Ireland
  1. Correspondence to Dr Ciarán McHale; ciaran.mchale{at}


We present a case of D-lactic acidosis presenting as a metabolic encephalopathy secondary to small intestinal bacterial overgrowth. This patient had a known history of short bowel syndrome. Of note, this case required the alteration of treatment to promote a sustained clinical and biochemical improvement. We discuss the pathophysiological mechanisms thought to be involved. We also review the current therapies as well as potential future strategies. This case highlights the importance of the prompt clinical recognition of signs and symptoms as well as the rapid initiation of management strategies to ameliorate this condition.

  • gastroenterology
  • malabsorption
  • fluid electrolyte and acid-base disturbances

Statistics from


  • Contributors CMH: conceptualisation, writing of the original draft, review and editing. EK: writing, review and editing. HOD: writing of the original draft. ES: supervision, writing, review and editing.

  • 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.

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

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.