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Short bowel syndrome

Small intestine insufficiency; Short gut syndrome; Necrotizing enterocolitis - short bowel

 

Short bowel syndrome is a problem that occurs when part of the small intestine is missing or has been removed during surgery. Nutrients are not properly absorbed into the body as a result.

Causes

 

The small intestine absorbs much of the nutrients found in foods we eat. When one half or more of our small intestine is missing, the body may not absorb enough food to stay healthy and maintain your weight.

Some infants are born missing part or much of their small intestine.

More often, short bowel syndrome occurs because much of the small intestine is removed during surgery. This type of surgery may be needed:

  • After gunshots or other trauma damaged the intestines
  • For someone with severe Crohn disease
  • For infants, often born too early, when part of their intestines dies

 

Symptoms

 

Symptoms may include:

  • Diarrhea
  • Fatigue
  • Pale, greasy stools
  • Swelling ( edema ), especially of the legs
  • Very foul-smelling stools
  • Weight loss
  • Dehydration

 

Exams and Tests

 

The following tests may be done:

  • Blood chemistry tests (such as albumin level )
  • Complete blood count (CBC)
  • Fecal fat test
  • Small intestine x-ray
  • Vitamin levels in the blood

 

Treatment

 

Treatment is aimed at relieving symptoms and ensuring the body receives enough nutrients.

A high-calorie diet that supplies:

  • Key vitamins and minerals, such as iron , folic acid, and vitamin B12
  • Enough carbohydrates, proteins, and fats

If needed, injections of some vitamins and minerals or special growth factors will be given.

Medicines to slow down the normal movement of the intestine can be tried. This may allow food to remain in the intestine longer.

If the body is not able to absorb enough nutrients, total parenteral nutrition (TPN) is tried. It will help you or your child get nutrition from a special formula through a vein in the body. Your health care provider will select the right amount of calories and TPN solution. Sometimes, you can also eat and drink while getting nutrition from TPN.

Small bowel transplantation is an option in some cases.

 

Outlook (Prognosis)

 

The condition may improve over time if it is due to surgery. Nutrient absorption may slowly get better.

 

Possible Complications

 

Complications may include:

  • Bacterial overgrowth in the small intestine
  • Nervous system problems caused by a lack of vitamin B12
  • Too much acid in the blood (metabolic acidosis due to diarrhea)
  • Gallstones
  • Kidney stones
  • Malnutrition
  • Weakened bones (osteomalacia)
  • Weight loss

 

When to Contact a Medical Professional

 

Call your provider if you develop symptoms of short bowel syndrome, especially after you have had bowel surgery.

 

 

Open References

References

Buchman AL. Short bowel syndrome. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease . 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 106.

Caplan M. Necrotizing enterocolitis and short bowel syndrome. In: Gleason CA, Devaskar SU, eds. Avery's Diseases of the Newborn . 9th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 73.

Semrad CE. Approach to the patient with diarrhea and malabsorption. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 140.

 
  • Digestive system

    Digestive system - illustration

    The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.

    Digestive system

    illustration

  • Digestive system organs

    Digestive system organs - illustration

    The digestive system organs in the abdominal cavity include the liver, gallbladder, stomach, small intestine and large intestine.

    Digestive system organs

    illustration

    • Digestive system

      Digestive system - illustration

      The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.

      Digestive system

      illustration

    • Digestive system organs

      Digestive system organs - illustration

      The digestive system organs in the abdominal cavity include the liver, gallbladder, stomach, small intestine and large intestine.

      Digestive system organs

      illustration

    A Closer Look

     

      Talking to your MD

       

        Self Care

         

          Tests for Short bowel syndrome

           
             

            Review Date: 5/11/2016

            Reviewed By: Subodh K. Lal, MD, gastroenterologist with Gastrointestinal Specialists of Georgia, Austell, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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