Short Bowel Syndrome: Common Questions

Introduction: Common Questions about Short Bowel Syndrome

What is short bowel syndrome?

Short bowel syndrome (SBS), also known as short gut, is broadly described as a condition in which nutrients are not properly absorbed because a large part of the small bowel is missing. This is most often due to defects existing at birth (congenital), or surgical removal of part of the small bowel. There may not be enough functioning bowel or surface area left in the remaining bowel to absorb needed water and nutrients from food. Sometimes, loss of normal function may occur even when the bowel length is intact. Typically, a loss of half or more of the small bowel will result in SBS.

Learn about the digestive system and how it works

What causes short bowel syndrome?

The main cause of short bowel syndrome is the surgical removal of half or more of the small intestine to treat intestinal diseases, injuries, or defects present at birth. 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.

What are the signs and symptoms of short bowel syndrome?

Diarrhea is the main symptom of short bowel syndrome. Diarrhea can lead to dehydration, malnutrition, and weight loss. Other symptoms may include:

  • fatigue,
  • pale greasy stools (steatorrhea),
  • swelling of lower extremities (edema)
  • Foul smelling stools
  • electrolyte losses

Vitamin and mineral losses can lead to some symptoms. Depending on which vitamin or mineral is deficient, symptom examples include:

  • visual disturbances
  • excessive dryness of the eyes
  • prickling or tingling feeling on the skin
  • muscle spasms
  • loss of coordination
  • loss of bone mass
  • easy bruising and/or prolonged bleeding
  • lack of energy (lethargy)
  • weakness
  • difficulty breathing on exertion

People with short bowel syndrome are also at risk for developing food sensitivities.

How is short bowel syndrome treated?

The aims of treatment for short bowel syndrome are to promote adaptation and maximize the use of the  existing bowel, maintain adequate nutritional status, and manage symptoms and complications. Complications can arise  as a result of the underlying condition and also, in connection with treatments.

The ultimate goal is for the patient to resume daily life as well as possible. Treatment involves some combination of:

  • Nutrition strategies
  • Managing gastric acid secretions, bacterial overgrowth, bile salt malabsorption, and diarrhea
  • Medications
  • Surgery

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.

What is intestinal adaptation?

Immediately following the surgery to remove part of the bowel (surgical resection), the intestine begins to adapt on its own for the loss of absorptive surface area. It undergoes various phases to increase absorption and maintain balance (homeostasis). This process, known as adaptation, occurs through structural changes that increase surface area in the remaining bowel. These physiological changes and adaptations can be separated into 3 phases: acute phase, adaptation phase and maintenance phase.

Learn more about all three phases

Points to Remember

  • Short bowel syndrome is a condition characterized by malabsorption – difficulties absorbing both nutrients and fluids.

  • People with short bowel syndrome cannot absorb enough water, vitamins, and other nutrients from food to sustain life.

  • Diarrhea is the main symptom of short bowel syndrome and can lead to dehydration, malnutrition, and weight loss.

  • Treatment may involve nutritional strategies, managing gastric acid secretions like bacterial overgrowth, bile salt malabsorption, and diarrhea, medications and surgery

  • Researchers are studying ways to help the small intestine that remains after surgery adapt and function better.

The Gutsy Perspective

The Gutsy Perspective is a Short Bowel Syndrome (SBS) research-project that investigates the quality of life of children, adults, and families that have been impacted by pediatric SBS.

Adapted from NIH Publication No. 09-4631; February 2009. This article is not copyrighted.

Page updated 02/2023

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