Short bowel syndrome is a condition in which a portion of your small or large intestine has been removed or doesn’t work properly. As a result, your body can’t properly absorb nutrients such as:
- vitamins
- minerals
- proteins
- fats
Some cases of short bowel syndrome are mild, while others cause far greater difficulties. Some people are born with this condition or develop it in childhood as a complication of fetal development issues. Others may develop it in adulthood.
Most commonly,
- intestinal atresia (a condition that results from being born with a narrowed small intestine or a missing portion of the small intestine)
- intestinal injury due to physical trauma
- sluggish movement within your intestines
- cancer or cancer treatment that affects your intestines
- scarring of your intestines due to Crohn’s disease, which causes obstruction in your digestive tract
- loss of blood flow to your intestines as a result of blood vessel blockage
Symptoms of short bowel syndrome can vary, but diarrhea is common. Because diarrhea can lead to dehydration and malnutrition, it’s a serious symptom and must be treated.
Other possible
- weight loss
- bodily weakness and fatigue
- cramping and bloating in your belly
- edema (swelling) in your legs
- nausea and vomiting
- foul-smelling or pale, greasy stool
- heartburn and gas
The symptoms of short bowel syndrome vary widely depending on how much of your functional intestine remains.
You may also experience the following symptoms as a result of malabsorption of specific nutrients:
Symptom | Cause |
dry skin and reduced muscle mass | dehydration and malabsorption of water |
vision problems | vitamin A deficiency |
seizures and irregular heartbeat | vitamin B deficiency |
muscle spasms and osteoporosis (weak bones) | vitamin D deficiency |
muscle coordination problems | vitamin E deficiency |
skin discoloration and bruising | vitamin K deficiency |
paleness, mental fog, and shortness of breath | iron deficiency |
hair loss and skin rashes | zinc deficiency |
A doctor will diagnose short bowel syndrome based on your medical history, a thorough physical examination, and the results of several clinical tests.
The doctor will ask you about your symptoms and any similar conditions that your close family members, such as your siblings and parents, have experienced.
Next, they will perform a complete physical examination, including listening to your abdominal area with a stethoscope.
Further diagnostic procedures may include:
- Imaging tests: Imaging methods such as X-rays, CT scans, an MRI scan, an upper GI series (barium study), and abdominal ultrasound imaging may reveal obstructed or narrowed areas in your intestinal tract or bowel and irregularities in other organs.
- Blood tests: Doctors may order tests to measure vitamin and mineral levels in your bloodstream, as well as a blood count to check for anemia.
- Fecal fat test: This test measures how well your body is absorbing fat. Your doctor will ask you to give a stool sample for this purpose.
There is currently no cure for short bowel syndrome.
However, it’s possible to manage the symptoms, improve your quality of life, and help prevent dangerous complications.
Nutrition and diet
Proper nutrition is the first line of defense in short bowel syndrome. The right diet will vary from person to person, depending on the condition’s cause and severity.
However, doctors will make the following recommendations for most people with short bowel syndrome:
- Eat frequently to stimulate intestinal absorption of nutrients and speed up intestinal adaption (the process by which the healthy portion of your intestine “learns” to compensate for sections that aren’t working properly or have been removed). The idea is to enjoy healthy snacks throughout the day, forgoing larger meals.
- Stay hydrated throughout the day by drinking water, broth, and non-caffeinated soft drinks. Children should also consume nonprescription rehydration solutions that are sold in most drugstores and food stores.
- Avoid foods that may cause diarrhea, such as those high in fiber, fat, or sugar.
- Eat thick, bland foods that can help control diarrhea, such as bananas, rice, oatmeal, applesauce, and toast.
- Take vitamin and mineral supplements according to the guidance of a doctor.
Your diet will usually be supplemented by additional forms of nutritional support. One possibility is enteral nutrition, which involves the delivery of nutrients via a stomach tube inserted through your nose or mouth. More commonly, you’ll receive intravenous delivery of fluids and nutrients, known as parenteral nutrition.
Total parenteral nutrition (TPN) involves supplying all your nutrients directly into your bloodstream, bypassing your digestive system entirely. TPN is typically temporary, except in the most severe cases.
Medication
Doctors may also prescribe a variety of medications for short bowel syndrome, including drugs that:
- help prevent diarrhea
- regulate the release of stomach acids
- increase your small intestine’s capacity to absorb nutrients
- inhibit the growth of intestinal bacteria
- stimulate bile flow
- protect your liver
Surgery
In some cases, you
- Bianchi procedure: a procedure that involves lengthening your bowel by cutting it in half and sewing one end to the other
- Stricturoplasty: a procedure to open up a narrowed part of your intestine while preserving its length
- Serial transverse enteroplasty: a procedure in which surgeons create a zigzag pattern of your intestines to increase their length
- Intestinal transplant: a procedure that is performed only in very severe cases
Complications that may result from short bowel syndrome include:
In addition, treatments may lead to complications such as:
- catheter-related infections, blood clots, and kidney or liver problems due to TPN
- organ rejection and infections after a transplant
In many cases, particularly if the condition occurs as a result of surgery, the symptoms of short bowel syndrome may get better over time. This will depend on factors such as how much healthy intestine remains intact and how well it adapts.
Generally, with proper medical management and self-care, your quality of life can improve.
Meanwhile, clinical trials for new treatments periodically become available. To learn more about clinical trials, you can visit ClinicalTrials.gov.