Your patient is a 39-year old high school guidance counselor whowas diagnosed with Chrone’s disease (an inflammatory bowel disease)when he was a teenager. Last year, he had a small bowel obstructionthat could not be relieved with nonsurgical procedures, and heunderwent emergency surgery that removed 80% of his ileum. Sincethe surgery, his stool has been oily. Why? (Hint: consider theconsequence of reduced enterohepatic circulation).
This patient also suffers from “bile acid diarrheaâ€. Why wouldthis surgery result in diarrhea? Why doesn’t this occur in ahealthy person?
