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Short bowel syndrome

Short bowel syndrome is a condition that occurs when part of the small intestine is missing or has been removed during surgery. Nutrients are not properly absorbed into the body (malabsorption) as a result.

Causes

When part of the small intestine is missing, there may not be enough surface area in the bowel to absorb enough nutrients from food. The this can happen when half or more of the bowel is removed during surgery or sections are missing due to a birth defect (congenital defect),

Risk factors include diseases of the small intestine that may require surgery, such as Crohn's disease. In infants, necrotizing enterocolitis is a common cause.

Symptoms

Exams and Tests

  • Blood chemistry tests (such as albumin level)
  • Complete blood count (CBC)
  • Fecal fat test
  • Small intestine x-ray
  • Vitamin levels in the blood

Treatment

Treatment is aimed at relieving symptoms. Treatments may include:

  • A high-calorie diet that supplies key vitamins and minerals, as well as carbohydrates, proteins, and fats
  • Injections of some vitamins and minerals
  • Vitamin B12, folic acid and increased iron in the diet to treat anemia
  • Medicines to slow down the normal movement of the intestine so food remains in the intestine longer
  • Injections of special growth factors
  • Tube feeding through a vein (parenteral nutrition) if normal feeding is not supplying enough nutrients
  • Small bowel transplantation in some cases

Outlook (Prognosis)

The condition may improve over time if it is due to surgery. Nutrient absorption may slowly get better.

Possible Complications

  • Bacterial overgrowth in the small intestine
  • Nervous system problems caused by a lack of vitamin B12
  • Too much acid in the blood (metabolic acidosis due to diarrhea)
  • Gallstones
  • Kidney stones
  • Malnutrition
  • Weakened bones (osteomalacia)
  • Weight loss

When to Contact a Medical Professional

Call your health care provider if you develop symptoms of short bowel syndrome, especially after you have had bowel surgery.

Alternative Names

Small intestine insufficiency

References

Semrad CE. Approach to the patient with diarrhea and malabsorption. In: Goldman L, Schafer AI, eds.Goldman's Cecil Medicine

Update Date 5/15/2014

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