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Short Bowel Syndrome |
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What is short bowel
syndrome?
Short bowel syndrome is a group of problems related to poor
absorption of nutrients that typically occurs in people who have
had half or more of their small intestine removed. The small
intestine and the large intestine, also called the colon, make up
the bowel. The small intestine is where most digestion of food and
absorption of nutrients occur. People with short bowel syndrome
cannot absorb enough water, vitamins, and other nutrients from
food to sustain life.
What
causes short bowel syndrome?
The main cause of short bowel syndrome is surgical removal of half
or more of the small intestine to treat intestinal diseases,
injuries, or defects present at birth.
In newborns, short bowel syndrome may occur following surgery to
treat conditions such as
-
necrotizing enterocolitis, a
condition that occurs in premature infants and leads to the
death of bowel tissue
-
congenital defects of the
bowel, such as midgut volvulus, omphalocele and gastroschisis,
jejunoileal atresia, internal hernia, and congenital short bowel
-
meconium ileus, a condition
associated with cystic fibrosis
In children and adults, short
bowel syndrome may occur following surgery to treat conditions
such as
- intussusception, a condition in which
part of the intestine folds into another part of the intestine
- Crohn’s disease, an inflammatory bowel
disease
- bowel injury from loss of blood flow due to a
blocked blood vessel
- bowel injury from trauma
- cancer and damage to the bowel caused by
cancer treatment
Short bowel syndrome can also be
caused by disease or injury that prevents the small intestine from
functioning as it should despite a normal length.
How is
short bowel syndrome treated?
The main treatment for short bowel syndrome is nutritional
support. Treatment may involve use of oral rehydration solutions,
parenteral nutrition, enteral nutrition, and medications. Oral
rehydration solutions consist of sugar and salt liquids.
Parenteral nutrition delivers fluids, electrolytes, and liquid
nutrients into the bloodstream intravenously—through a tube placed
in a vein. Enteral nutrition delivers liquid food to the stomach
or small intestine through a feeding tube.
Specific treatment depends on the severity of the disease:
-
Mild short bowel syndrome
treatment involves eating small, frequent meals; taking fluid
and nutritional supplements; and using medications to treat
diarrhea.
-
Moderate short bowel syndrome
treatment is similar to that for mild disease with the addition
of intravenous fluid and electrolyte supplements as needed.
-
Severe short bowel syndrome
treatment involves use of parenteral nutrition and oral
rehydration solutions. Patients may receive enteral nutrition or
continue normal eating even though most of the nutrients are not
absorbed. Both enteral nutrition and normal eating stimulate the
remaining intestine to function better and may allow patients to
discontinue parenteral nutrition. Some people with severe short
bowel syndrome require parenteral nutrition indefinitely.
Long-term treatment and recovery
depend in part on what sections of the small intestine were
removed, how much remains, and how well the remaining small
intestine adapts over time.
Intestinal transplantation may be an option for some patients for
whom other treatments have failed and who have complications from
long-term parenteral nutrition. These complications include blood
infections, blood clots, and liver failure, which can lead to the
need for liver transplantation.
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