Short Bowel Syndrome
Definition
Short bowel syndrome is a complication that can occur in people who have a large part or all of their small intestine removed.
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Causes
Short bowel syndrome occurs when half or more of the small intestine is removed. It reduces the absorption of vitamins and minerals from food.
Risk Factors
Factors that may increase the chances of short bowel syndrome:
- Crohn disease —most common reason for the removal of the small intestine
- Vascular problems
- Premature birth or very low birth weight
- Necrotizing enterocolitis
- Intestinal atresias
- Gastroschisis
Symptoms
Symptoms of short bowel syndrome may include:
- Diarrhea
- Cramping
- Bloating
- Heartburn
- Malnourishment
- Poor growth
- Dehydration
- Weakness
- Fatigue
- Depression
- Weight loss
- Food sensitivities
Diagnosis
Your doctor will ask about your symptoms and medical history. A physical exam will be done. Blood tests may also be performed to check for nutritional and absorption problems.
Treatment
Talk with your doctor about the best treatment plan for you. Treatment options include:
Nutrition
If you are malnourished, your doctor may give you food, fluid, and electrolytes through an IV. You will be advised to gradually increase your caloric intake and avoid certain foods. Initially, your diet will be high-protein, low-fat, and lactose-free.
Medications
In addition to changing your diet, you may need to take vitamin and mineral supplements. Antidiarrheal medications and medications that slow the contraction and relaxation of the intestinal muscles can also slow your digestion so you can absorb more nutrients. Depending on your symptoms, your doctor may prescribe an H2 blocker, a proton pump inhibitor, cholestyramine, and/or octreotide.
Surgery
Transplantation of small bowel is an option for those who cannot maintain their nutritional status with other treatments.
Prevention
There are no current guidelines to prevent short bowel syndrome.
RESOURCES:
American Gastroenterological Association
http://www.gastro.org
National Institute of Diabetes and Digestive and Kidney Diseases
https://www.niddk.nih.gov
CANADIAN RESOURCES:
Canadian Association of Gastroenterology
https://www.cag-acg.org
Canadian Digestive Health Foundation
http://www.cdhf.ca
REFERENCES:
Short bowel syndrome. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T115699/Short-bowel-syndrome. Updated January 5, 2018. Accessed April 3, 2018.
Short bowel syndrome. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/short-bowel-syndrome. Updated July 2015. Accessed April 3, 2018.
Last reviewed March 2018 by EBSCO Medical Review Board Daus Mahnke, MD Last Updated: 5/7/2014