Treatments for short bowel syndrome include medication, changes to diet, and surgery.
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What Is Short Bowel Syndrome (SBS)?
The small intestine is like a tube.
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It is about 20 feet long in adults.
It is located in the abdomen and runs between the stomach and the large intestine.
Food is chewed and swallowed, then travels down theesophagusto the stomach.
When the small bowel is shortened, it could lead to fewer vitamins and minerals being absorbed.
The small intestine has different sections, each of which absorbs different nutrients.
This could lead to SBS.
However, SBS could also occur in someone with more than 200 cm of bowel.
This is called functional SBS.
What Causes Short Bowel Syndrome?
In most cases, SBS occurs after there have been one or more surgeries on the small intestine.
There are a few other causes of SBS that are found in children.
How Is Short Bowel Syndrome Diagnosed?
There’s not just one, single test that can help provide a diagnosis of SBS.
A combination of tests can help diagnose SBS, including:
How Is Short Bowel Syndrome Treated?
SBS has three phases.
An acute phase happens directly after the causative event (such as surgery).
Third is the chronic phase.
In about half of people with SBS, the condition doesnt reverse or improve enough to go without treatment.
They may continue to need intravenous (IV) nutrition for a time.
About 48% of people diagnosed with SBS still need to receive nutrition via an IV after five years.
A variety of treatments might be used or needed for SBS.
Nutrition might be given in other ways for people in the acute phase of SBS.
Parenteralnutritionis when nutrients, vitamins, minerals, and fluids are given through an IV.
The IV might be placed in the arm or neck, or through acentral veinunder the collarbone.
It might be used for either the short-term or the long-term.
In the short term, parenteral nutrition might be started directly after having surgery on the bowel.
Some people with chronic SBS may need parenteral nutrition at home.
Parenteral nutrition can be partial if some nutrients can be taken by mouth.
It can also be total when the digestive system isnt working at all.
A specialist healthcare provider may help ensure the right nutrients are being given through parenteral nutrition.
Enteralnutrition may also be used to get nutrients.
It is given through a tube inserted into the stomach or the small intestine.
The tube could be placed down through the nose for temporary use or through the abdomen for long-term use.
It may be referred to as afeeding tube.
There is no specialized diet for all people living with SBS.
Even one appointment can help people understand how best to support their nutrition while living with SBS.
Medication
Treating SBS includes ensuring nutrition is being managed and symptoms are treated.
Treatment is individualized because each person with SBS will have different conditions and concerns.
Various types of surgery might be used.
Autologous intestinal reconstruction surgery (AIRS) may be used in SBS.
It can be performed in several ways.
The goal is to increase the length of the small intestine and improve absorption.
Some procedures may be done by segmenting the small bowel and reconnecting it to increase the length.
Intestinal transplantationis another surgical option.
This is when the small intestine and possibly other digestive organs are replaced.
It is generally reserved for people who have life-threatening SBS.
Intestinal transplants are still uncommon and can cause complications.
However, technique and five-year survival rates are improving.
Lifestyle Changes
SBS is a complex condition.
It is important to work closely with the healthcare team, which may include many members.
Ask questions and be open about how SBS affects all aspects of your life.
It may be difficult or even embarrassing at times, but being honest could help improve care.
This can include family, friends, and the healthcare team.
Asking for and accepting help in everything from getting to and from medical appointments to grocery shopping is important.
Connecting with a patient support group is also useful.
Working with a mental health professional may be helpful for people with SBS, as well.
Counseling may be temporary or continue long term.
What Complications May Develop From Short Bowel Syndrome?
The complications of SBS can include those that are from the condition as well as from needing nutritional care.
They can include:
What Is the Outlook for Short Bowel Syndrome?
Unfortunately, there is no cure for SBS.
However, the management of SBS has improved in recent years.
Various treatments can help people live better lives while managing the condition.
Many people with SBS dont need parenteral nutrition, or they only need it for about a year.
For those with a shorter intestine, parenteral nutrition might be needed for the long term.
The outlook for SBS is going to be different based on several factors.
For that reason, its difficult to broadly predict outcomes.
People with SBS should work with their healthcare providers to understand the potential for complications and their prognosis.
Summary
SBS is a complex condition.
It may occur after surgery or treatment for cancer.
The body may adapt over time, and treatment might no longer be needed.
In some cases, SBS may turn into a chronic condition that needs management.
Treating SBS includes managing nutrition with the help of the healthcare team and optimally, a dietitian.
A team of healthcare providers will be needed to manage all the aspects of SBS.
The prognosis for SBS is mixed, and will depend on the severity of the disease and overall health.
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Updated Feb 1, 2021.
