Short Bowel Syndrome

Short Bowel Syndrome (SBS) is a condition in which the body cannot properly absorb nutrients because part of the small intestine is missing.

Adults have 480 cm of small intestine divided into duodenum, jejunum and ileum. When the small intestine measures 180 cm, there is a risk of developing SBS. At 60 cm or less, there is not enough intestine to allow minimum digestion and absorption and the patient becomes dependent on parenteral nutrition (non-oral intake). This state is also known as intestinal failure.

SBS can be present at birth or it could be caused by surgical removal of parts of your small intestine. Conditions that require surgical removal of portions of the small intestine, like Crohn’s disease, blood clots, cancers, or trauma, can lead to SBS.

Other causes may include strangulated large hernias or inflammation of the intestines as a result of radiation therapy.

The most common symptoms of SBS are diarrhea with large amounts of fat, weight loss, abdominal pain, gas, bloating, fatigue and weakness.

Some implications of the disease will depend upon the part of the intestines that have been removed, since each part has a specific role absorbing specific nutrients, vitamins, and minerals. In these cases, symptoms might present as:

• Dermatitis (fatty acids)
• Inflammation in the mouth and tongue (niacin, riboflavin)
• Neurological problems (Vitamin E)
• Pallor and weakness (iron deficiency)

Once SBS is suspected in a patient, treatment can begin as soon as possible. Using a multimodal approach, treatment aims to improve intestinal function, decrease parenteral nutrition dependency, and avoid intestinal transplantation. Methods may be nutritional, pharmacological, or surgical.