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Short Bowel Syndrome by Krisha McCoy, MS

Definition

Short bowel syndrome is a complication that can occur in people who have part or all of their small intestine removed.

The Small Intestines

Causes

Short bowel syndrome occurs when so much of the small intestine is removed (usually half or more) that there is inadequate surface area in the small intestine for the absorption of vitamins and minerals from food.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

The following factors are thought to increase the risk of short bowel syndrome:

Crohn's disease (the most common reason for the removal of the small intestine)
Vascular problems
Premature birth

Symptoms

Symptoms of short bowel syndrome may include:

Diarrhea
Cramping
Bloating
Heartburn
Malnourishment
Dehydration
Weakness
Fatigue
Depression
Weight loss
Bacterial infections
Food sensitivities

Diagnosis

Your doctor will ask about your symptoms and medical history, and perform a physical exam. He or she will also likely perform blood tests 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 receive vitamin and mineral supplementation. 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 antagonist, proton pump inhibitor, cholestyramine , and/or octreotide .

Surgery

Transplantation of small bowel is an option for patients who cannot maintain their nutritional status with the above treatments.

Prevention

There is no known way to prevent short bowel syndrome.

RESOURCES:

American Gastroenterological Association http://www.gastro.org
National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/index.htm

CANADIAN RESOURCES:

Canadian Association of Gastroenterology http://www.cag-acg.org/
Canadian Digestive Health Foundation http://www.cdhf.ca/

References:

Short bowel syndrome. DynaMed website. Available at: http://dynamed102.ebscohost.com/Detail.aspx?id=115699 . Accessed May 22, 2007.
Short bowel syndrome. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/shortbowel/index.htm . Accessed May 22, 2007.

Last reviewed September 2012 by Marcin Chwistek, MD

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