Flosgen’s Syndrome: A Review

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Table of Contents

Introduction
Effects of Flosgen’s Syndrome
How to Reduce Symptoms of Flosgen’s Syndrome
Conclusion
References

Introduction

The small intestine is a component of the digestive system. Major digestion and absorption of water occurs here. Optimal health of this organ is important in promoting the nutrition of an individual. Flosgen’s Syndrome is a congenital disorder that affects this organ. It is named after the person who discovered it, Werner Flosgen. It is a rare medical condition. Like other congenital disorders, the disease manifests itself in newborns. In most cases, the patients are born with the syndrome. In rare circumstances, children can develop the medical condition within the first one month of their life.

Flosgen’s syndrome is fairly new medical condition. It is characterised by an abnormal development of the small intestines. The normal diameter of this organ is 3 centimetres. However, individuals suffering from the syndrome have intestines that are double this size. Usually, the affected organ is 6 centimetres wide (Thomson et al. 2003). There are no changes in the structure and length of the intestines. The number and size of blood vessels also remains the same. However, there is a significant change in the circumference and surface area of the affected region. The number of villi present in the small intestines of affected persons is double that found in normal individuals.

Effects of Flosgen’s Syndrome

Abdominal Cramping After Meals

The syndrome is associated with the abnormal development of the small intestines. The size of this organ among individuals suffering from the disorder is double that observed in normal persons in terms of diameter. Increase in the girth of the intestines translates to a rise in the circumference (Schottenfeld, Beebe-Dimmer & Vigneau 2009). The other aspects of the organ, such as length, blood supply, and the structure of the walls, remain constant.

However, there is an increase in the surface area occupied by the small intestines within the abdominal region. Once an individual suffering from the disorder takes a meal, the food moves to the stomach and eventually finds its way to the small intestines. Once they are filled with food, the intestines become distended. The abdomen becomes clogged, leading to congestion. An individual experiences abdominal cramping as a result of the increased surface area covered by the intestine. The development causes excessive discomfort among the individuals (Gill, Heuman & Mihas 2001).

Flosgen’s syndrome is associated with impaired digestion. The intestinal wall is lined with muscles. The muscles are used for the purposes of propelling food in a progressive manner towards the colon. They also press the food to facilitate its uniform mixing with digestive enzymes. The pressing also helps in absorption. The increased diameter of the small intestines affects the efficiency of these muscles, especially those involved in the forward propulsion of food (Johnson, DiSario & Grady 2004).

When food is moving through normal-sized intestines, it fills the cavity, enhancing the efficiency of abdominal muscles. However, this is not the case in persons suffering from Flosgen’s syndrome. The increase in diameter means that food will not move through the intestines as a compact mass. As a result, it takes long to empty the contents of the ileum. The transition to the colon is delayed. After taking subsequent meals, an individual suffering from the disorder will experience the accumulation of food on the intestines as a result of the slowed rate of digestion. The entire gastro-intestinal tract becomes congested as a result of the food accumulation (Thomson et al., 2003). As a result, abdominal cramping occurs.

The enlargement of the diameter of the intestines reduces the contact between the food and the inner intestinal walls. As a result of this, the food consumed by an individual suffering from the disorder does not adhere to the regions as it normally should. Digestive enzymes are found on the intestinal walls, especially along the ileum (Kummar, Ciesielski & Fogarasi 2002). When contact with these regions is lost, the rate of digestion is slowed down. As a result, food overstays in the intestines.

Hampered digestion also leads to the accumulation of gasses (Thomson et al. 2003). Since patients suffering from Flosgen’s syndrome have a larger intestinal volume compared to normal persons, the empty spaces are filled with gasses. As a result, they become distended. Due to their distension, they press on other visceral organs, such as the liver and the bladder, resulting in discomfort. When the situation persists, abdominal cramping may occur.

Vitamin Deficiency

There is a close relationship between the efficiency of the digestion tract and nutrient absorption (Thomson et al. 2003). Flosgen’s syndrome leads to an increase in the diameter of the small intestines. As a result, there is poor contact between food and the lining of the intestinal wall, which has digestives enzymes on it. Due to the inefficiency, digestion in the small intestines is lowered. Nutrients, such as vitamins, are not released from the food in adequate amounts. As a result, deficiency of the nutrients is experienced.

The medical condition is associated with a number of signs and symptoms. Such indicators include, among others, diarrhoea and vomiting. The two signs are associated with the expulsion of food from the body. The food is often rich in nutrients since it has not undergone complete digestion. Vitamins are some of the components contained in vomit or excrement. When either of the two conditions persists, the patient may show signs of malnutrition (Lin & Stoll 2006). It is one of the reasons why cases of vitamin deficiency are common among patients suffering from the health condition.

Fat in Faeces

The presence of fat in the faecal matter is also a common clinical sign presented by individuals suffering from Flosgen’s syndrome. The situation arises from impaired digestion. Lipids in the diet are mainly in form of triglyceride molecules and neutral fat particles. The two compounds are large in size and cannot be absorbed across the wall of the small intestines. For their absorption to take place, the two forms of fats need to undergo emulsification.

The process is supported by two major enzymes. The two include bile acids (which are produced in the liver) and pancreatic lipase. The enzymes are transported from the organs where they are produced to the intestines via ducts. The ducts are located along the inner intestinal wall. However, with the increased diameter of the small intestines, the food fails to come into contact with adequate amounts of the two digestive enzymes available (Thomson et al. 2003).

Lack of proper contact with the intestinal walls inhibits adequate mixing of the food through the contraction of the muscles of the small intestines. It is important to note that the churning of the muscles plays a major role in the absorption of lipids that have already been digested into fatty acids and mono-glyceride molecules (Kessmann 2006). Due to the increased diameter of the small intestines, the pressure applied on the chime by the intestinal walls is reduced. As a result, the diffusion of the monoglyceride molecules through the organ and into the enterocyte is inhibited. Consequently, the presence of fat in the faeces of persons suffering from Flosgen’s syndrome is a common occurrence.

How to Reduce Symptoms of Flosgen’s Syndrome

Flosgen’s syndrome can be diagnosed using a number of clinical signs and symptoms. They include abdominal cramping, deficiency of vitamins, and presence of fat in the faeces of the patient. Currently, there is no cure or medical intervention that has been developed for the medical condition. The development is especially so considering the fact that the condition is very new in the medical field. However, a number of measures can be taken to reduce the effects of the symptoms associated with the disorder. The approaches aim at dealing with the causes of the symptoms to improve the quality of life among patients (Dipalma et al. 2007).

Abdominal cramping is one of the major symptoms associated with Flosgen’s syndrome. It is mainly as a result of the congestion of the gastro-intestinal tract due to the impaired digestion. The symptom can be alleviated by increasing the fibre content in the food consumed by persons suffering from the disorder (Schatzkin et al. 2008). Research has shown that this strategy is associated with faster movement of food along the bowel.

High intake of fluids by the patients will also help ease congestion in the small intestines. In addition, it compensates for the water lost through diarrhoea. Use of anti-laxatives will also help promote movement of food in the small intestines (Dipalma et al. 2007). Exercises, such as ‘yoga’, have also been found to provide relief for abdominal cramping. Patients should be discouraged from taking meals that induce these symptoms.

The problem associated with vitamin deficiencies can be dealt with through the supplementation of these nutrients among persons suffering from Flosgen’s syndrome. Supplementation is achieved through the use of tablets and injections (Thomson et al. 2003). The intervention should be carried out regularly using adequate quantities to ensure that the patients receive amounts that are similar to those among persons whose small intestines have a normal diameter.

Dealing with the presence of fats in the faeces of patients poses a major challenge to practitioners. The reason behind this is that digestion of fats depends on the physiology of the small intestines. In spite of this, the problem can be dealt with through the provision of fat supplements to patients suffering from Flosgen’s syndrome. The fats should be provided in form of monoglycerides, which are readily absorbed in the small intestines without the need of undergoing further digestion. The patients can also be encouraged to adopt diets with high energy content to compensate for the undigested fat (Rush et al. 2002).

Conclusion

Flosgen’s syndrome is a relatively new discovery in the medical field. As a result, little research has been done on the disorder. No cure or medication is currently available for the medical condition. Information available on the disorder has shown that it is characterised by impaired digestion. As a result, it leads to a number of digestion-related problems, such as abdominal cramping, deficiency of vitamins, and presence of fats in the faecal material. In the absence of readily available treatment procedures, the only viable remedy to improve the quality of life of persons suffering from the disorder entails alleviating the symptoms associated with it.

References

Dipalma, A, Cleveland, M, McGowan, J & Herrera, J 2007, ‘A randomised, multicenter, placebo-controlled trial of polyethylene glycol laxative for chronic treatment of chronic constipation’, American Journal of Gastroenterology, vol. 102 no. 7, pp. 1436-1441.

Gill, S, Heuman, M & Mihas, A 2001, ‘Small intestinal neoplasms’, Journal of Clinical Gastroenterology, vol. 33 no. 1, pp. 267-282.

Johnson, C, DiSario, J & Grady, M 2004, ‘Surveillance and treatment of periampullary and duodenal adenomas in familial adenomatous polyposis’, Current Treatment Options for Gastroenterology, vol. 7 no. 2, pp. 79-89.

Kessmann, J 2006, ‘Hirschsprung’s disease: diagnosis and management’, American Family Physician, vol. 74 no. 8, pp. 1319-1322.

Kummar, S, Ciesielski, E & Fogarasi, M 2002, ‘Management of small bowel adenocarcinoma’, Oncology, vol. 16 no. 1, pp. 1364-1369.

Lin, W & Stoll, B 2006, ‘Necrotising enterocolitis’, Lancet, vol. 368 no. 9543, pp. 1271-1283.

Rush, C, Patel, M, Plank, D, Fergus, R 2002, ‘Kiwifruit promotes laxation in the elderly’, Asia Pacific Journal of Clinical Nutrition, vol. 11 no, 2, pp. 164-168.

Schatzkin, A, Park, Y, Leitzmann, F, Hollenbeck, R & Cross, J 2008, ‘Prospective study of dietary fibre, whole grain foods, and small intestinal cancer’, Gastroenterology, vol. 135 no. 1, pp. 1163-1167.

Schottenfeld, D, Beebe-Dimmer, J & Vigneau, D 2009, ‘The epidemiology and pathogenesis of neoplasia in the small intestine’, Annals of Epidemiology, vol. 19 no. 1, pp. 58-69.

Thomson, A, Drozdowski, L, Iordache, C, Thomson, B, Vermeire, S, Clandinin, M & Wild, G 2003, ‘Small bowel review: normal physiology, part 1’, Digestive Science, vol.48 no. 8, pp. 1546-1564.

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