53-years-old with mental status changes

D-lactic acidosis, a complication of short bowel syndrome, presents with a variety of neurological symptoms and metabolic acidosis. Treatment is hydration, replacement of nutritional deficiency replacement, and selective antibiotics. Prevention entails complex carbohydrate diet and vitamin and mineral supplements. The authors have stated that they do not have a significant financial interest or other relationship with any product manufacturer or provider of services discussed in this article. The authors also do not discuss the use of off-label products, which includes unlabeled, unapproved, or investigative products or devices.