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.
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:
In children and adults, short bowel syndrome may occur following surgery to treat conditions such as:
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.
Diarrhea is the main symptom of short bowel syndrome. Diarrhea can lead to dehydration, malnutrition, and weight loss. These problems can be severe and can cause death without proper treatment. Other symptoms may include:
People with short bowel syndrome are also at risk for developing food sensitivities.
After removal of a large portion of the small intestine, the remaining small intestine goes through a process of adaptation that increases its ability to absorb nutrients. The inner lining grows, increasing its absorptive surface area. Intestinal adaptation can take up to 2 years to occur.
The main treatment for short bowel syndrome is nutritional support. Treatment may involve use of:
Specific treatment depends on the severity of the disease:
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.