Short bowel syndrome
Small intestine insufficiency; Short gut syndrome; Necrotizing enterocolitis - short bowelShort 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.
Not properly absorbed into the body
Malabsorption involves problems with the body's ability to take in (absorb) nutrients from food.
Read Article Now Book Mark ArticleCauses
The small intestine absorbs much of the nutrients found in foods we eat. When two-thirds or more of the 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
Crohn disease
Crohn disease is a disease where parts of the digestive tract become inflamed. It most often involves the lower end of the small intestine and the be...
Read Article Now Book Mark Article - For infants, often born too early, when part of their intestines dies
Part of their intestines dies
Necrotizing enterocolitis (NEC) is the death of tissue in the intestine. It occurs most often in premature or sick babies.
Read Article Now Book Mark Article - When blood flow to the small intestine is reduced due to blood clots or narrowed arteries
Symptoms
Symptoms may include:
- Diarrhea
- Fatigue
Fatigue
Fatigue is a feeling of weariness, tiredness, or lack of energy.
Read Article Now Book Mark Article - Pale, greasy stools
- Swelling (edema), especially of the legs
Edema
Swelling is the enlargement of organs, skin, or other body parts. It is caused by a buildup of fluid in the tissues. The extra fluid can lead to a ...
Read Article Now Book Mark Article - Very foul-smelling stools
Foul-smelling stools
Foul-smelling stools are stools with a very bad odor. They very often have to do with what you eat, but may be a sign of a medical condition....
Read Article Now Book Mark Article - Weight loss
Weight loss
Unexplained weight loss is a decrease in body weight, when you did not try to lose the weight on your own. Many people gain and lose weight. Uninten...
Read Article Now Book Mark Article - Dehydration
Exams and Tests
The following tests may be done:
- Blood chemistry tests (such as albumin level)
Albumin level
Albumin is a protein made by the liver. A serum albumin test measures the amount of this protein in the clear liquid portion of the blood. Albumin c...
Read Article Now Book Mark Article - Complete blood count (CBC)
Complete blood count
A complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...
Read Article Now Book Mark Article - Fecal fat test
Fecal fat
The fecal fat test measures the amount of fat in the stool. This can help gauge the percentage of dietary fat that the body does not absorb....
Read Article Now Book Mark Article - Small intestine x-ray
- Vitamin levels in the blood
Treatment
Treatment is aimed at relieving symptoms and ensuring the body receives enough hydration and nutrients.
A high-calorie diet that supplies:
- Key vitamins and minerals, such as iron, folic acid, and vitamin B12
Iron
Iron is a mineral found in every cell of the body. Iron is considered an essential mineral because it is needed to make hemoglobin, a part of blood ...
Read Article Now Book Mark ArticleVitamin B12
Vitamin B12 is a water-soluble vitamin. Water-soluble vitamins dissolve in water. After the body uses what it needs of these vitamins, leftover amo...
Read Article Now Book Mark Article - 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. Medicines to lower the amount of stomach acid may also be needed.
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.
Total parenteral nutrition (TPN)
Total parenteral nutrition (TPN) is a method of feeding that bypasses the gastrointestinal tract. A special formula given through a vein provides mo...
Read Article Now Book Mark ArticleSmall bowel transplantation is an option in some cases.
A medicine called teduglutide is available to help the bowel adjust to the shorted intestine. It helps in specific situations. Ask your provider if it might help you.
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 (This problem can be treated with vitamin B12 injections.)
- Too much acid in the blood (metabolic acidosis due to diarrhea)
Acidosis
Acidosis is a condition in which there is too much acid in the body fluids. It is the opposite of alkalosis (a condition in which there is too much ...
Read Article Now Book Mark Article - Gallstones
Gallstones
Gallstones are hard deposits that form inside the gallbladder. These may be as small as a grain of sand or as large as a golf ball.
Read Article Now Book Mark Article - Kidney stones
Kidney stones
A kidney stone is a solid mass made up of tiny crystals. One or more stones can be in the kidney or ureter at the same time.
Read Article Now Book Mark Article - Dehydration
- Malnutrition
Malnutrition
Malnutrition is the condition that occurs when your body does not get enough nutrients.
Read Article Now Book Mark Article - Weakened bones (osteomalacia)
- Weight loss
When to Contact a Medical Professional
Contact your provider if you develop symptoms of short bowel syndrome, especially after you have had bowel surgery.
References
Buchman AL. Short bowel syndrome. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 106.
Semrad CE. Approach to the patient with diarrhea and malabsorption. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 126.
Venick RS. Short bowel syndrome. In: Wyllie R, Hyams JS, Kay M, eds. Pediatric Gastrointestinal and Liver Disease. 6th ed. Philadelphia, PA: Elsevier; 2021:chap 35.
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 - 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 - 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 - illustration
The digestive system organs in the abdominal cavity include the liver, gallbladder, stomach, small intestine and large intestine.
Digestive system organs
illustration
Review Date: 5/14/2024
Reviewed By: Jenifer K. Lehrer, MD, Department of Gastroenterology, Aria - Jefferson Health Torresdale, Jefferson Digestive Diseases Network, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.