Sewell R B, Hoffman N E, Smallwood R A
Med J Aust. 1978 Dec 16;2(13):598-601. doi: 10.5694/j.1326-5377.1978.tb131769.x.
Fourteen patients with ileal dysfunction due to resection or bypass were encountered over an 18-month period. Symptoms had been present for a mean period of 1.8 years. Diarrhoea was a universal symptom, and varied from mild to incapacitating. Weight loss, due in part to malabsorption and in part to the patients' fear of eating, occurred in 10 of 14 patients. The chief metabolic abnormalities were steatorrhoea and hypokalaemia. Vitamin B12 deficiency, folate deficiency, anaemia, hypoalbuminaemia, hypocalcaemia, hypomagnesaemia, hyperoxaluria, and an abnormal prothrombin ratio were less frequently seen. Treatment with cholestyramine and/or long-chain fat restriction effectively reduced diarrhoea in every case, and this was supplemented by replacement of specific deficiencies. There was little added benefit from non-specific antidiarrhoeal agents. It was found that the major symptoms of ileal dysfunction are readily treated, but that attention should also be given to a number of nutritional deficiencies.
在18个月的时间里，共遇到14例因回肠切除或旁路手术导致回肠功能障碍的患者。症状出现的平均时长为1.8年。腹泻是普遍症状，程度从轻度到使人衰弱不等。14名患者中有10名出现体重减轻，部分原因是吸收不良，部分原因是患者害怕进食。主要的代谢异常是脂肪泻和低钾血症。维生素B12缺乏、叶酸缺乏、贫血、低白蛋白血症、低钙血症、低镁血症、高草酸尿症和异常凝血酶原比值较少见。使用消胆胺和/或限制长链脂肪进行治疗在每种情况下均有效减轻了腹泻，并通过补充特定缺乏症进行辅助。非特异性止泻药几乎没有额外益处。发现回肠功能障碍的主要症状易于治疗，但也应关注一些营养缺乏问题。
