1. Kaya Shepherd-Poppick's Home Page Welcome to Kaya Estlyn Shepherd-Poppick's Home Page! I was born with a rare condition called Short Category Health Conditions and Diseases short bowel syndrome......Kaya Estlyn ShepherdPoppick's Home Page New York City Kid with Short BowelSyndrome gets a Small Bowel and Liver Transplant and Moves to Montana. http://users.montanadsl.net/~jelb7869/

WELCOME TO KAYA SHEPHERD-POPPICK'S PERSONAL HOME PAGE! This site was last updated on 1/13/03 email us at: kaya@montanadsl.net Welcome to Kaya Estlyn Shepherd-Poppick's Home Page! This site was established to keep friends and family posted on current events in Kaya's life, as well as to share our experience with Kaya's small-bowel and liver transplant. We hope that Kaya's story is an encouraging one to other families facing similar challenges. Hi!!! My name is Kaya Estlyn. I was born on November 9th, 1998, at St. Vincent's Hospital in New York City, and for the past year and a half have been living in Missoula, MT. I love it here in Montana, and have been having a great time playing outdoors and meeting lots of nice people. My favorite things to do these days include taking gymnastics classes, going to story-time at the library, and playing with all of my good friends. My life is great now, but had a rough first year. I was born without much small intestine, and had to spend months and months in the hospital. I've had many, many surgeries (some big, some little), and I've been sick a lot. When the doctors told us that I needed to have a transplant, my parents took me to different hospitals and put me on several organ donor lists, but it took a long time to get my new liver and intestine. Thank goodness my new organs finally came October 20th, 1999! Now I'm feeling much better. My life is great since my transplant...my parents and I would like to thank everyone who has given us support and love over the last several years: family, friends, doctors, and nurses - We could not have done it with out you!

2. Short Bowel Syndrome A brief look at this syndrome and what it is, the symptoms, reasons and treatment.Category Health Conditions and Diseases short bowel syndrome......short bowel syndrome is a group of problems affecting people who havehad half or more of their small intestine removed. The most http://www.niddk.nih.gov/health/digest/summary/shortbo/shortbo.htm

Short bowel syndrome is a group of problems affecting people who have had half or more of their small intestine removed. The most common reason for removing part of the small intestine is to treat Crohn's disease. Diarrhea is the main symptom of short bowel syndrome. Other symptoms include cramping, bloating, and heartburn. Many people with short bowel syndrome are malnourished because their remaining small intestine is unable to absorb enough water, vitamins, and other nutrients from food. They may also become dehydrated, which can be life threatening. Problems associated with dehydration and malnutrition include weakness, fatigue, depression, weight loss, bacterial infections, and food sensitivities. Short bowel syndrome is treated through changes in diet, intravenous feeding, vitamin and mineral supplements, and medicine to relieve symptoms. Additional Information on Short Bowel Syndrome The National Digestive Diseases Information Clearinghouse collects resource information on digestive diseases for the Combined Health Information Database (CHID). CHID is a database produced by health-related agencies of the Federal Government. This database provides titles, abstracts, and availability information for health information and health education resources. To provide you with the most up-to-date resources, information specialists at the clearinghouse created an automatic search of CHID. To obtain this information, you may

3. Intestinal Disease Foundation - Short-Bowel Syndrome short bowel syndrome. short bowel syndrome (SBS) occurs whenever the functions of the small bowel have been removed from http://www.intestinalfoundation.org/library/short.shtml

Useful Words Irritable Bowel Syndrome Diverticular Disease Short-Bowel Syndrome ... Children and IBD Short Bowel Syndrome Short bowel syndrome (SBS) occurs whenever the functions of the small bowel have been removed from the body by disease or surgery. The normal small bowel varies in length between 10 and 28 feet and is divided into three sections. The first section is the duodenum and is located just after the stomach. The duodenum is relatively short, measuring only about 10-12 inches. The next section is the jejunum, which is the largest but not the longest section. The jejunum comprises only 2/5 of the rest of the small intestine but is the largest section because its many folds give it an increased diameter. The final 3/5 of the small bowel is the ileum. The level of difficulty experienced by a patient with SBS is often determined by which sections are affected. One half of the small bowel can be removed without significant disability resulting, especially if the ileum is not involved. However, the more intestine removed, the greater the disability a patient will experience. The entire jejunum can be removed without much disability except for lactose intolerance. The ileum can compensate for all the losses of the jejunum except the lactose deficiency. Removal of the ileum accounts for most of the problems seen in short bowel syndrome since it is responsible for the absorption of fats, bile salts, and B12. Causes back to top Signs and Symptoms Signs and symptoms of SBS vary greatly depending on how much of the small bowel is lost and how long the malabsorption (inadequate absorption of nutrients) has been allowed to continue. Generally speaking, weight loss, diarrhea, abdominal bloating, fatigue, and steatorrhea (fat in the stool) are present in SBS. If the malabsorption is long-standing, other symptoms may appear that relate to the nutrient that is deficient.

4. THE MERCK MANUAL, Sec. 3, Ch. 30, Malabsorption Syndromes short bowel syndrome is often the result of extensive intestinal resection. http://www.merck.com/pubs/mmanual/section3/chapter30/30g.htm

5. Diseases And Conditions -- Discovery Health -- Short Bowel Syndrome short bowel syndrome is a condition caused by surgery that removes part of the small intestine, such as an ileostomy. short bowel syndrome. By Minot Cleveland, MD http://health.discovery.com/diseasesandcond/encyclopedia/2414.html

short bowel syndrome By Minot Cleveland, MD Images (click to view larger image) Short bowel syndrome is a condition caused by surgery that removes part of the small intestine, such as an ileostomy What is going on in the body? The small bowel carries food from the stomach to the large bowel, which attaches to the rectum and anus. It plays an important role in digestion. Vitamins, minerals, salts, and important fats are absorbed through the small bowel. Removal of part of the small bowel decreases the area to absorb these nutrients. Many people can tolerate removal of up to 50% to 60% of the small bowel without having problems. However, when more than this amount or a key part of small bowel is removed, symptoms often occur. These symptoms make up what is called the short bowel syndrome. What are the signs and symptoms of the condition? The main symptoms of this condition are abdominal pain, or distress , and diarrhea . Malabsorption, or poor absoption, of important nutrients may lead to weight loss , low blood counts including anemia , and vitamin deficiencies.

6. Short Bowel Syndrome short bowel syndrome. DEFINITION A malabsorptive disorder occurring after congenital or postnatal acquired resection http://www.icondata.com/health/pedbase/files/SHORTBOW.HTM

Pediatric Database (PEDBASE) Discipline: GI Last Updated: 4/06/94 SHORT BOWEL SYNDROME DEFINITION: A malabsorptive disorder occurring after congenital or postnatal acquired resection of the small intestine. EPIDEMIOLOGY: incidence: ? age of onset: any age risk factors: congenital - atresia, gastroschisis, malrotation acquired - massive resection - volvulus, NEC PATHOGENESIS: 1. Etiology long-term prognosis depends on the amount, and which section, of small bowel is removed: loss of the distal small bowel is more serious than loss of the proximal small bowel resection of proximal small bowel: massive malabsorption of water, electrolytes, fat, protein, carbohydrates, vitamins, minerals transient problem with significant improvement in months as the distal small bowel can compensate resection of distal small bowel (ileum): no improvement in bile acid or vit B12 absorption as proximal bowel cannot compensate CLINICAL FEATURES: 1. Gastrointestinal Manifestations 1. Classical Triad weight loss, anemia, diarrhea 2. Symptoms Related to Malabsorption

7. Short Bowel Syndrome short bowel syndrome. By Lori S. Brizee MS,RD,CD short bowel syndromeDefinition of short bowel syndrome. short bowel syndrome (SBS http://staff.washington.edu/growing/Assess/SBS.htm

Short Bowel Syndrome By Lori S. Brizee MS,RD,CD, Clinical Dietitian, Children's Hospital and Regional Medical Center, Seattle, Washington Definition Early Nutritional Support Long Term Nutritional Support Nutrient Deficiencies ... Definition of Short Bowel Syndrome Short Bowel Syndrome (SBS) is defined as malabsorption resulting from anatomical or functional loss of a significant length of the small intestine. Most commonly this occurs after bowel resection in the newborn period (i.e., secondary to necrotizing enterocolitis ). The amount of bowel that must be lost to produce malabsorption is variable and depends on which section(s) is/are lost, and whether the ileocecal valve is preserved. The normal length of small intestine is approximately 300 to 850 cm for an adult, 200 to 250 cm for an infant over 35 weeks gestation, and approximately 100 to 120 cm for a premature infant, less than 30 weeks gestation. Loss of greater than 80% of the small bowel is associated with increased requirement for parenteral nutrition support, and decreased overall survival. When the ileocecal valve is lost, the resulting bacterial contamination of the small intestine mandates more small intestine for tolerance of oral/enteral feeding. The small intestine consists of the duodenum, jejunum and ileum. The majority of carbohydrate and protein absorption takes place in the duodenum and jejunum. Fats and fat soluble vitamins, however are absorbed in the ileum. Bile salts are excreted from the liver into the duodenum; these are required for the absorption of long chain fatty acids and fat soluble vitamins in the ileum. Vitamin B12 binds to intrinsic factor (produced in the stomach) and is also absorbed in the terminal ileum. Fluids and electrolytes are predominantly absorbed in the ileum and in the colon. When the duodenum and/or jejunum are resected, the ileum can largely adapt to perform their absorptive functions. However, the duodenum and jejunum cannot adapt to perform the functions of the ileum. Thus, resection of the duodenum or jejunum is generally much better tolerated than resection of the ileum.

8. Short Bowel Syndrome Slide 1 of 11 http://silja.rsp.is/hringur/fraedsluefni/slides/studentar/st_1/sld001.htm

9. Short Bowel Syndrome: Etiology, Pathophysiology And Management Case 2 short bowel syndrome Etiology, Pathophysiology and Management. CME Objectives.short bowel syndrome Etiology, Pathophysiology and Management. http://www.clevelandclinicmeded.com/selected_topics/shortbowel/intro1.asp

Case 2: Short Bowel Syndrome: Etiology, Pathophysiology and Management Activity Release Date: 9/27/2001 Activity Expiration Date: 9/27/2003 CME Objectives Short Bowel Syndrome: Etiology, Pathophysiology and Management Upon completing this activity, the participant will be able to: List the most frequent causes of the short bowel syndrome and describe the physiologic consequences of this condition. Discuss the potential long-term complications of extensive intestinal resection. Recommend dietary modification, fluid, electrolyte, mineral, and vitamin supplementation according to extent and location of intestinal resection. Identify the medications which may be used to optimize absorption and minimize secretion in patients with short bowel syndrome. Author: Douglas L. Seidner, MD

10. Short Bowel Syndrome short bowel syndrome Etiology, Pathophysiology and Management. Case2 short bowel syndrome Etiology, Pathophysiology and Management. http://www.clevelandclinicmeded.com/selected_topics/shortbowel/summary/article.h

Short Bowel Syndrome: Etiology, Pathophysiology and Management The Cleveland Clinic Center for Continuing Education Douglas L. Seidner, MD Director, Nutrition Support Team Department of Gastroenterology The Cleveland Clinic Foundation Cleveland, OH Case 2: Short Bowel Syndrome: Etiology, Pathophysiology and Management Short bowel syndrome occurs after an extensive resection of the small bowel. Patients with this problem present with chronic diarrhea, dehydration, electrolyte abnormalities and malnutrition as a result of severe maldigestion and malabsorption. Treatment spans a continuum, which ranges from those who can be managed with proper dietary manipulation to those who will require parenteral nutrition, and may be candidates for intestinal transplantation. I will review normal gastrointestinal function, the effect

11. Short Bowel Syndrome - The Transplant Center At Fairview-University Medical Cent The Transplant Center — short bowel syndrome is the result of substantial lossor malfunction of absorptive intestinal surface. What is short bowel syndrome? http://www.fairviewtransplant.org/shortbowel.asp

Behavioral/Chemical Dependency Blood/Marrow Transplant Brain Tumor Center ... and the Family University of Minnesota Academic Health Center UMPhysicians 'Ask the Doctor' Radio Press Room ... Fairview Rehabilitation Services Hospitals: Children's Fairview- University Medical Center Lakes Northland ... Milestones Transplant Types Heart Kidney Liver Lung ... United Network for Organ Sharing Newsletters/Annual Reports Select from list Summer 2002 Fall 2001 Spring 2001 Fall 2000 Winter 1999 Fall 1999 Spring 1999 1999 Annual Report 1998 Annual Report Fairview-University Medical Center The Transplant Center 516 Delaware St. SE Box 482, Room 2-200 Minneapolis, MN 55455 (800) 328-5465 (kidney, lung, liver, intestine, pancreas) (800) 478-5864 (heart) The Transplant Center is a partnership of the following entities: Adult Heart Pediatric Heart Clinical Trials Fairview-University website ... Clinical Trials What is short bowel syndrome?

12. Short Bowel Syndrome; Patient Outcomes - The Transplant Center Patient Outcomes According to the International Intestinal Transplant Registry,more than 470 bowel transplants have been performed worldwide. http://www.fairviewtransplant.org/outcomes.asp

Behavioral/Chemical Dependency Blood/Marrow Transplant Brain Tumor Center ... and the Family University of Minnesota Academic Health Center UMPhysicians 'Ask the Doctor' Radio Press Room ... Fairview Rehabilitation Services Hospitals: Children's Fairview- University Medical Center Lakes Northland ... Milestones Transplant Types Heart Kidney Liver Lung ... United Network for Organ Sharing Newsletters/Annual Reports Select from list Summer 2002 Fall 2001 Spring 2001 Fall 2000 Winter 1999 Fall 1999 Spring 1999 1999 Annual Report 1998 Annual Report Fairview-University Medical Center The Transplant Center 516 Delaware St. SE Box 482, Room 2-200 Minneapolis, MN 55455 (800) 328-5465 (kidney, lung, liver, intestine, pancreas) (800) 478-5864 (heart) The Transplant Center is a partnership of the following entities: Adult Heart Pediatric Heart Clinical Trials Fairview-University website ... Clinical Trials Patient Outcomes According to the International Intestinal Transplant Registry, more than 470 bowel transplants have been performed worldwide. At the time of transplantation, most of the patients were children 13 years of age or younger. Fifty-five percent of the patients were hospitalized at the time of transplantation, and only 45 percent were at home. At one year, graft survival rates for solitary bowel/intestinal transplants as well as for combined bowel/liver transplants were 65 percent. One-year patient survival for recipients of solitary bowel or intestinal transplants was approximately 80 percent, with 65 percent for combined liver and bowel transplants. Patients who required combined transplantation (liver and bowel) have shown higher morbidity and mortality because of advanced disease in both organs.

13. SHORT BOWEL SYNDROME: CONTROLLING DIARRHEA short bowel syndrome CONTROLLING DIARRHEA. Diarrhea is a difficult problemto address, especially for the person with short bowel syndrome (SBS). http://www.ccfa.org/medcentral/library/compl/sbs.htm

Home News Updates Medical Library Research Information ... Glossary SHORT BOWEL SYNDROME: CONTROLLING DIARRHEA Diarrhea is a difficult problem to address, especially for the person with short bowel syndrome (SBS). The reasons for diarrhea vary widely with the type of resection or the degree of lost bowel function. Recognizing that a strategy which works for one SBS patient may not work for another, this article reviews some of the most recent dietary management ideas found in professional literature. Also included is information from the 1995 American Society for Parenteral and Enteral Nutrition (ASPEN) Clinical Congress. How SBS Leads to Diarrhea The gastrointestinal (GI) tract consists of two main partsthe small intestine and the large intestine (also called the colon). In adults, the small intestine measures approximately 20 feet and the colon approximately 7 feet. SBS is defined in many ways, but often it refers to a small intestine that has been resected or shortened by 50%, or more. Loss of the small intestine is especially problematic if it involves the loss of the lower ileal region and the ileo-cecal valve. The GI tract is the major transport system for nutrients to enter and be used by the body. Food and fluids that are taken by mouth must be digested or changed chemically so the nutrients can be absorbed and used for energy, growth and maintenance of life. Specifically, the small intestine digests and absorbs food, and the large intestine absorbs leftover salt, minerals and water. In the short bowel patient, the colon also conserves calories. The remaining indigestible waste products are fermented by bacteria, lubricated and stored until they are expelled as feces through the rectum. Any significant change in the GI tract, such as a loss of any portion of the tract, can cause a breakdown of this very efficient process. These changes may result in the rapid transit of nutrients through the GI tract or diarrhea.

14. MEDLINEplus Medical Encyclopedia: Short Bowel Syndrome short bowel syndrome. Call for an appointment with your health care providerif symptoms of short bowel syndrome develop. Prevention Return to top. http://www.nlm.nih.gov/medlineplus/ency/article/000237.htm

Skip navigation Medical Encyclopedia Other encyclopedia topics: A-Ag Ah-Ap Aq-Az B-Bk ... Z Short bowel syndrome Contents of this page: Illustrations Alternative names Definition Causes, incidence, and risk factors ... Prevention Illustrations Digestive system Digestive system organs Alternative names Return to top Small intestine insufficiency Definition Return to top A condition of malabsorption related to the surgical removal or disease of a large portion of the small intestine. Causes, incidence, and risk factors Return to top The lack of adequate surface to absorb nutrients from food occurs when specialized areas of the bowel are removed. When one-half of the bowel or more is removed during surgery, the risk of small bowel syndrome is great. Risk factors include diseases of the small intestine that may require surgical intervention such as regional enteritis or Crohn's disease Necrotizing enterocolitis is a common cause of this syndrome in infants. Symptoms Return to top Stools - floating Stools - foul smelling Diarrhea ... Pallor Signs and tests Return to top Chem 20 that reveals signs of malabsorption (inadequate absorption of nutrients from the intestinal tract) CBC that reveals anemia Stool examination ( fecal fat Treatment Return to top The treatment is for the relief of symptoms.

15. Short Bowel Syndrome short bowel syndrome is a group of problems affecting people who have had half ormore of their small intestine removed. Subscribe now . short bowel syndrome. http://healthlink.mcw.edu/article/930591212.html

Search Articles: search tips Please Take the HealthLink Survey Email this article Print this article Find related articles: By topic: Digestive System By keywords: Receive Health Link via email! Subscribe now >> Short Bowel Syndrome Short bowel syndrome is a group of problems affecting people who have had half or more of their small intestine removed. The most common reason for removing part of the small intestine is to treat Crohn's disease. Diarrhea is the main symptom of short bowel syndrome. Other symptoms include cramping, bloating, and heartburn. Many people with short bowel syndrome are malnourished because their remaining small intestine is unable to absorb enough water, vitamins, and other nutrients from food. They may also become dehydrated, which can be life threatening. Problems associated with dehydration and malnutrition include weakness, fatigue, depression, weight loss, bacterial infections, and food sensitivities. Short bowel syndrome is treated through changes in diet, intravenous feeding, vitamin and mineral supplements, and medicine to relieve symptoms.

16. Re: Short Bowel Syndrome/ Subject Re short bowel syndrome/ Forum The Gastroenterology and Liver DiseasesForum Topic Area Malabsorption Posted by HFHSM.D.ym on October 25, 1998 at http://www.medhelp.org/forums/gastro/archive/4321.html

Special Notices: Advertisements Med Help International A not-for-profit organization Questions in The Gastroenterology Forum are curently being answered by Kevin Pho, M.D., who is board certified in Internal Medicine. Subject: Re: Short Bowel Syndrome/ Forum: The Gastroenterology and Liver Diseases Forum Topic Area: Malabsorption Posted by HFHSM.D.-ym on October 25, 1998 at 13:08:58: In Reply to: Short Bowel Syndrome/ posted by Eydie on October 25, 1998 at 00:38:37: : I experienced a traumatic loss of all but 19" of small intestine s/p colectomy for a dysfunctional colon (very complicated medical/surgical hx, born with exstrophy of bladder). I have been on TPN now for 20 months. I have asked what criteria is used to decrease TPN and theres been little discussion about this. I currently cycle TPN 12h/d. Weight stable 118lbs. @ 5"3'. : The TPN does not bother me it has become a part of my life. But I just want to make sure my liver stays as healthy as possible. Am I being impatient? I fear long term complications to my liver. : What levels of LFT's should alert me.

17. Short Bowel Syndrome/ Subject short bowel syndrome/ Topic Area Malabsorption Forum The Gastroenterologyand Liver Diseases Forum Question Posted By Eydie on Sunday, October 25 http://www.medhelp.org/perl6/gastro/archive/4324.html

Special Notices: Advertisements Med Help International A not-for-profit organization Questions in The Gastroenterology Forum are curently being answered by Kevin Pho, M.D., who is board certified in Internal Medicine. Subject: Short Bowel Syndrome/ Topic Area: Malabsorption Forum: The Gastroenterology and Liver Diseases Forum Question Posted By: Eydie on Sunday, October 25, 1998 : I experienced a traumatic loss of all but 19" of small intestine s/p colectomy for a dysfunctional colon (very complicated medical/surgical hx, born with exstrophy of bladder). I have been on TPN now for 20 months. I have asked what criteria is used to decrease TPN and theres been little discussion about this. I currently cycle TPN 12h/d. Weight stable 118lbs. @ 5"3'. : The TPN does not bother me it has become a part of my life. But I just want to make sure my liver stays as healthy as possible. Am I being impatient? I fear long term complications to my liver. : What levels of LFT's should alert me. : I've had 6 UTI's this year usually occur q4-6w.

18. 1Up Health > Short Bowel Syndrome > Causes, Incidence, And Risk Factors Of Short Comprehesive information on short bowel syndrome (Small intestine insufficiency). Shortbowel syndrome Causes, Incidence, and Risk Factors. Alternative names http://www.1uphealth.com/health/short_bowel_syndrome_info.html

1Up Health Short bowel syndrome Alternative Medicine Clinical Trials ... Health Topics A-Z Search 1Up Health Short bowel syndrome Information Short bowel syndrome Causes, Incidence, and Risk Factors Alternative names : Small intestine insufficiency Definition : A condition of malabsorption related to the surgical removal or disease of a large portion of the small intestine. Causes, Incidence, and Risk Factors The lack of adequate surface to absorb nutrients from food occurs when specialized areas of the bowel are removed. When one-half of the bowel or more is removed during surgery, the risk of small bowel syndrome is great. Risk factors include diseases of the small intestine that may require surgical intervention such as regional enteritis or Crohn's disease Necrotizing enterocolitis is a common cause of this syndrome in infants. Previous Next Jump to Another Section of this Guide Definition Causes, Incidence, and Risk Factors Symptoms Prevention Diagnosis, Signs, and Tests Treatment ... Calling your Health Care Provider Related Tools and Utilities Search Books on Amazon: Read Articles on eLibrary: Health Products on drugstore.com:

19. 1Up Health > Short Bowel Syndrome (Small Intestine Insufficiency) Information Comprehesive information on short bowel syndrome (Small intestine insufficiency). 1UpHealth Diseases Conditions short bowel syndrome. http://www.1uphealth.com/health/short_bowel_syndrome.html

1Up Health Alternative Medicine Clinical Trials Health News ... Health Topics A-Z Search 1Up Health Short bowel syndrome Information Guide Alternative names : Small intestine insufficiency Definition : A condition of malabsorption related to the surgical removal or disease of a large portion of the small intestine. Jump to a Section of this Guide Definition Causes, Incidence, and Risk Factors Symptoms Prevention ... Calling your Health Care Provider Related Tools and Utilities Search Books on Amazon: Read Articles on eLibrary: Health Products on drugstore.com: Anemia Crohn's disease Malabsorption Malnutrition ... More More Topics Diarrhea Fatigue Folic acid (folate) Iron in diet ... More Search 1Up Health A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is the first of its kind, requiring compliance with 53 standards of quality and accountability, verified by independent audit. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial reviewers . A.D.A.M. is also a founding member of Hi-Ethics (www.hiethics.com) and subscribes to the principles of the Health on the Net Foundation (www.hon.ch). Home Contact Us Privacy Links Directory

20. Short Bowel Syndrome - ICQ Interest Groups - ICQ.com Back to Homepage Groups Health Support Diseases Disorders short bowel syndrome ICQ Interest Groups short bowel syndrome, http://web.icq.com/groups/browse_folder?tid=6329

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