Short bowel syndrome

Short bowel syndrome is condition of food malabsorption related to disease or the surgical removal of a large portion of the small intestine.

When areas of the small intestine are removed by surgery, there may not be enough surface area left in the remaining bowel to absorb enough nutrients from food.

This condition is particularly likely to develop when one-half or more of the bowel is removed during surgery. Risk factors include diseases of the small intestine that may require surgical intervention, such as Crohn's disease. Necrotizing enterocolitis is a common cause of this syndrome in infants.

• Pale, greasy stools
• Particularly foul-smelling stools
• Diarrhea
• Edema
• Weight loss
• Fatigue

• Chem 20 (reveals signs of malabsorption)
• CBC (reveals anemia)
• Fecal fat test

Treatment is aimed at relieving symptoms.

A high-calorie and low-residue diet supplying essential vitamins and minerals is necessary. A low-residue diet is easy to digest and absorb. Anemia is treated with vitamin B-12, folic acid, and increased dietary iron. Medications may be given to lengthen the time nutrients spend in the small intestine.

Parenteral nutrition (tube feeding through a vein or stomach tube) is often necessary if normal feeding is not delivering enough nutrients. Once the patient has stabilized, however, a return to normal eating may be tried.

The condition may improve over time if it occurs as a result of surgery. Improvement of nutrient absorption and lengthening of the time the food spends in the intestine usually occurs with recovery from surgery.

• Weight loss
• Malnutrition
• Weakened bones
• Combined systems disease (a degeneration of the nervous system caused by not having enough vitamin B-12)
• Gallstones
• Bacterial overgrowth
• Metabolic acidosis
• Kidney stones

Call for an appointment with your health care provider if symptoms suggestive of short bowel syndrome develop, particularly if you recently had bowel surgery.