Short Bowel Syndrome

The small intestine is where most digestion of food and absorption of nutrients occur. People with short bowel syndrome cannot absorb enough water, vitamins, and other nutrients from food to live because half or more of the small intestine was removed. There may not be enough surface area left in the remaining bowel to absorb enough nutrients from food.

Causes

In newborns, short bowel syndrome may occur following surgery to treat conditions such as:

  • A very short length of small intestine or intestine that is dying (necrotizing enterocolitis).
  • Birth defects of the bowel.
  • A condition related to cystic fibrosis.

In children and adults, short bowel syndrome may occur following surgery to treat conditions such as:

  • Part of the intestine folds into another part of the intestine (intussusception).
  • Crohn’s disease – an inflammatory bowel disease.
  • Bowel injury from loss of blood flow from a blocked blood vessel.
  • Bowel injury from a physical injury (trauma).
  • Cancer and damage to the bowel caused by cancer treatment.

Symptoms

Diarrhea is the main symptom of short bowel syndrome. Diarrhea can lead to dehydration, malnutrition, and weight loss. These problems can be severe and cause death without the right treatment. Other symptoms include:

  • Cramping
  • Bloating
  • Heartburn
  • Weakness and fatigue

People are also at risk for developing food sensitivities.

Diagnosis/Testing

Collecting the child’s medical history is very important for the doctor to make a diagnosis. The doctor will have the child undergo an Upper GI Series with small bowel follow-through to see how much of the bowel remains. Other possible tests include:

  • Blood chemistry tests
  • Complete blood count (CBC)
  • Fecal fat test
  • Vitamin levels in the blood

Treatment

Treatment may include:

  • A high-calorie diet that supplies essential vitamins and minerals, and certain types of carbohydrates, proteins, and fats.
  • Some vitamins and minerals by injection (if needed).
  • Treatment for low blood (anemia) with vitamin B-12, folic acid, and more dietary iron.
  • Medicines to slow down the normal movement of the intestine
  • Nutritional Support Therapy

Placing the child on total parenteral nutrition (TPN) provides pre-digested nutrients that are easier for your child’s digestive system to absorb. As the remaining small bowel begins to work, small amounts of food may be eaten by mouth. Enteral nutrition may provide additional nutrients to the child through an NG tube, G-tube, or G-J tube. The goal is for the child to get nutrients by mouth and have the small intestine absorb the needed nutrients.

In severe cases, the child may require surgery to lengthen the small bowel, or have a bowel transplant.