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intestinal (enteric) hyperoxaluria

Etiology: - bowel surgery (resection of small intestine) - Crohn's disease - ileostomy - Roux-en-Y gastric bypass surgery Pathology: - undigested fatty acids bind calcium freeing intestinal oxalate for absorption Laboratory: - 24 hour urine oxalate > 50 mg Management: 1) cholestyramine 4 g with meals 2) oral calcium loading (calcium carbonate or calcium citrate supplements) 3) adequate hydration

Related

urinary calculus (stone, nephrolithiasis, urolithiasis)

General

hyperoxaluria

References

  1. Harrison's Principles of Internal Medicine, 13th ed. Isselbacher et al (eds), McGraw-Hill Inc. NY, 1994, pg 1330
  2. Medical Knowledge Self Assessment Program (MKSAP) 16, 17 American College of Physicians, Philadelphia 2012, 2015
  3. Kumar R, Lieske JC, Collazo-Clavell ML et al Fat malabsorption and increased intestinal oxalate absorption are common after Roux-en-Y gastric bypass surgery. Surgery. 2011 May;149(5):654-61. PMID: 21295813