A Simple Guide to Short Bowel Syndrome, Diagnosis, Treatment and Related Conditions

This book describes Short Bowel Syndrome, Diagnosis and Treatment and Related Diseases

"A short bowel means that the person must eat less at every meal or take 4 to 5 small meals every day"

Short bowel syndrome is a disorder in which some section of the small or large intestine has been removed or does not function properly.

As a result, people with short bowel syndrome cannot properly absorb nutrients, such as:

1. Vitamins
2. Minerals
3. Proteins
4. Fats

Some patients with short bowel syndrome have mild presentations while others develop far more difficulties.

Some patients have this disorder as a complication linked to birth defects.

Other times short bowel syndrome develops in adulthood.

Short bowel syndrome (SBS) in adults is depicted as less than 180 to 200 centimeters of remaining small bowel (normal length 275 to 850 cm) resulting in the need for nutritional and fluid supplements.

The normal length of small bowel in an adult, beginning from the duodenojejunal flexure, is between 275 to 850 centimeters.

About 9 liters of fluid pass through the small bowel every day in the form of oral fluids, saliva, gastric, biliary, and pancreatic secretions.

On average, about 7 liters of those fluids are taken up in the small bowel and 2 liters in the large bowel.

The large, healthy bowel obtains up about 150 kilocalories per day but can obtain up to 1000 kilocalories per day in those patients with malabsorption.

The absorption of most nutrients happens in the first 100 centimeters of the jejunum.

B12 and bile salts are taken in the last 100 centimeters of the ileum; magnesium is taken in the terminal ileum and proximal colon; water and sodium absorption happen throughout the bowel.

Patients manifest with signs and symptoms of malabsorption such as weight loss, diarrhea, steatorrhea, dehydration, malnutrition, and electrolyte imbalance.

Patients are treated using either lifelong parenteral nutrition or intestinal transplantation.

While there is no accepted guideline for SBS in children, the requirement for intravenous supplementation when having less than 25% of remaining small bowel that is expected for gestational age has been indicated.

About 75% of cases of SBS develop after a single large resection of bowel.

In the remaining 25% SBS happen after multiple resections.

Around 66% of patients who develop SBS survive their early hospitalization, and a similar number survive their first year after developing SBS.

The age and underlying disorder mainly determine a patient's long-term prognosis.

Most often short bowel syndrome develops after surgical removal of a section of the small intestine.

This surgery is performed to treat different types of intestinal disorders such as:

1. Being born with a narrowed small intestine, or missing a section of this part of the digestive system (intestinal atresia)
2. Injury to the intestines from physical trauma
3. Sluggish movement within the intestines
4. Cancer or cancer treatment that affects the intestines
5. Scarring of the intestines due to Crohn's disease, producing obstruction in the digestive tract
6. Loss of blood flow to the intestines as a result of blood vessel blockage

SBS can happen from extensive surgical resection or congenital intestinal diseases.

The most frequent pathologies that lead to SBS in adults are:

1. Crohn disease
2. Mesenteric ischemia
3. Radiation enteritis

The most frequent symptoms are:

1. Malnutrition
2. Weight loss
3. Diarrhea
4. Electrolyte imbalance

Proper nutrition is the first treatment for people with short bowel syndrome.

Medicines and surgery is sometimes needed if proper nutrition treatment fails.

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