D-lactic acidosis: an underrecognized complication of short bowel syndrome.
Level 5 - mechanism / opinion, no new human data
Narrative review without systematic search or primary empirical data
PubMed 25977687 · doi:10.1155/2015/476215
What was done
This narrative review summarizes the mechanism, clinical presentation, diagnostic evaluation, and treatment strategies for D-lactic acidosis (D-lactate encephalopathy) in patients with short bowel syndrome.
What was found
The abstract reports no numerical data, effect sizes, or participant numbers. It describes the pathophysiology where unabsorbed carbohydrates are fermented by colonic bacteria into D-lactic acid, reducing colonic pH and propagating further D-lactate production. Accumulation in blood leads to neurologic symptoms including delirium, ataxia, and slurred speech. Management involves correcting systemic acidosis, restricting dietary carbohydrates to reduce bacterial substrate, and using antibiotics to clear the responsible colonic flora.
Why it matters
It highlights an underrecognized and potentially confusing cause of metabolic acidosis and encephalopathy in patients with short bowel anatomy.
Limits
The abstract provides no empirical patient data, sample sizes, or systematic review methodology. Recommendations and mechanisms are based on narrative synthesis and clinical reasoning rather than controlled experimental trials.
Cited by
- supports D-lactate is neurotoxic.