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Short bowel syndrome

Small intestine insufficiency; Short gut syndrome; Necrotizing enterocolitis - short bowel

Short 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.

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Digestive system
Digestive system organs

Causes

The small intestine absorbs much of the nutrients found in foods we eat. When two-thirds 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:

Symptoms

Symptoms may include:

Exams and Tests

The following tests may be done:

Treatment

Treatment is aimed at relieving symptoms and ensuring the body receives enough hydration and nutrients.

A high-calorie diet that supplies:

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.

Small bowel transplantation is an option in some cases.

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:

When to Contact a Medical Professional

Call your provider if you develop symptoms of short bowel syndrome, especially after you have had bowel surgery.

Related Information

Malabsorption
Crohn disease
Necrotizing enterocolitis
Weight loss - unintentional
Pernicious anemia
Gallstones
Acidosis
Kidney stones

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.

Kaufman SS. Short bowel syndrome. In: Wyllie R, Hyams JS, Kay M, eds. Pediatric Gastrointestinal and Liver Disease. 5th ed. Philadelphia, PA: Elsevier; 2016:chap 35.

Semrad CE. Approach to the patient with diarrhea and malabsorption. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 131.

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Review Date: 5/27/2020  

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 Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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