All About Short Bowel Syndrome

Short bowel syndrome is more common in adults than in children. This condition involves lifelong limitations, but it can get better.
All About Short Bowel Syndrome

Last update: 21 September, 2021

Short bowel syndrome is a complex condition characterized by the physical or functional loss of a segment of the intestinal surface. The main causes are congenital disorders and intestinal infarction or mesenteric ischemia.

This condition makes it very hard to stay healthy. Short bowel syndrome makes it hard to absorb nutrients, which creates problems. Despite everything, through a process of functional and structural adaptation of the intestine, you can improve its absorption.

However, the prognosis for short bowel syndrome depends on the length and condition of the organ. In addition, it depends on the cause of the problem and other factors. Let’s take a closer look.

What is short bowel syndrome?

Short bowel syndrome is a condition that occurs when a part of the small intestine is lost. A child may have been born without it or they could have had it removed in surgery, for instance. Additionally, the area could have stopped working. This causes serious metabolic and nutritional problems.

However, not any lost part of the small intestine leads to short bowel syndrome. Specialists can only confirm it if the length of the remaining part of the intestine can’t absorb properly.

In general, this condition occurs artificially when there are two of the following surgeries:

  • Terminal jejunostomy: Part of the jejunum, ileum, and colon is missing.
  • Jejuno-colic anastomosos: The ileum and the ileocecal valve are missing, so the jejunum and colon connect.

A person with this condition needs macronutrient and electrolyte supplements to stay healthy. For kids, it’s important for them to grow. Sometimes they need parenteral feeding or through a vein so they don’t become malnourished.

A nurse drawing blood.

Symptoms and causes

According to the data available, the main underlying cause of short bowel syndrome is mesenteric ischemia or intestinal infarction, with 30% of cases. Then, there’s tumor obstruction, with 20%, and Crohn’s disease, with 20%. Finally, less common are radical enteritis and chronic pseudo-obstruction or other disorders.

In other countries the numbers are similar. On the other hand, in children, the main causes are congenital and perinatal problems.

Necrotizing enterocolitis, which is severe inflammation in the newborn’s colon, is more common in premature babies or those who spend more time in the neonatal care unit.

As we mentioned earlier, missing part of the intestine makes it harder to absorb nutrients. This causes a series of symptoms, like:

  • Diarrhea
  • Pale, greasy stools
  • Very foul odor in stools
  • Weight loss
  • Dehydration
  • Fatigue

To determine if this condition is present, the doctor will usually do laboratory tests. For example, this includes blood chemistry tests, complete blood count, blood vitamin levels, and stool fat tests. Additionally, they may order a small intestine X-ray.

A woman holding cardboard intestines.

The main goal of treatment is to ensure that the body receives the nutrients it needs and to relieve symptoms. To do this, specialists take the following steps:

  • Nutritional therapy involves following a special diet that includes nutritional supplements suitable for the patient. In some cases, you may need to use an intravenous or feeding tube.
  • Medications. In these cases, administering drugs is necessary. Some medicines help control diarrhea and improve intestinal absorption.
  • Surgery. Sometimes it’s necessary to perform surgery to lengthen the intestine, called autologous intestinal reconstruction. On other occasions, you need surgery to slow nutrients from passing through the intestine. In addition, you could even need a small intestine transplant.

The short intestine evolves differently

This condition improves with treatment, especially after surgery. In any case, follow-ups with the professional team are imperative for the rest of the patient’s life.

Also, complications can appear. For example, bacteria spreading in the small intestine, malnutrition, or problems in the nervous system form a vitamin B12 deficiency. Finally, it’s not easy to handle, and only gastroenterology specialists are trained to deal with it.

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