Short Bowel Syndrome
Short bowel syndrome is the extreme loss of
small intestine or its function due to disease or surgery, to
the extent that there isn’t enough of it left to absorb
Symptoms of Short Bowel Syndrome
The symptoms of short bowel syndrome are:
- Pain in the stomach or abdomen, or under the right ribcage
- Steatorrhea or foul-smelling stool
- Stool that “floats” or are oily and sticky
- Indigestion and other symptoms of peptic ulcer
- Fluid retention
- Fatigue and weakness
- Severe weight loss
Because of the body can’t absorb enough nutrients, patients
with short bowel syndrome often exhibit symptoms of nutrient and
vitamin deficiencies, such as:
- Anemia due to iron, folic acid, and/or vitamin
- Skin rashes and scaling of the skin or hyperkeratosis
due to vitamin A deficiency
- Bruising and blood in urine, due to vitamin K deficiency
- Muscle spasm and bone pain, due to vitamin D and calcium deficiency
- Osteoporosis due to calcium deficiency
Children diagnosed with short bowel syndrome are also often slow
in growth or development, due to lack of nutrition.
How Is It Diagnosed?
Your doctor would perform the following tests to diagnose this
- Medical history
A history of bowel surgery or digestive ailments may point to
the cause of short bowel syndrome.
- Physical examination
Jaundice, loss of muscle mass and wasting, visible signs of
skin scaling and rashes, and diminished sensation in the hands
and feet due to vitamin deficiencies are diagnosed by physical
- Blood tests
Elevated liver enzymes, abnormal levels of electrolytes and
potassium are observed in blood tests.
- Stool examination
Causes of Short Bowel Syndrome
Short bowel syndrome can be caused by:
- Bypass surgery for extremely obese patients
Here, the small intestine is shortened to reduce its ability
to absorb nutrients. It is no longer performed because of
potential side effects and complications, such as short
- Surgical removal of the small intestine damaged by disease
- Crohn’s disease
This digestive disorder is marked by inflammation of the digestive
tract (anywhere between the mouth and the anus). If the small
intestine walls are inflamed, then it may lead to short bowel
- Necrotising enterocolitis
Reduced blood supply to the walls of the small intestine lead
to dead tissues that have to be surgically removed. This condition
commonly affects prematurely-born babies and is the leading
cause of short bowel syndrome in infants.
A spontaneous tangling or twisting of the small intestine, where
the blood supply to the surrounding tissue is cut off, thus
causing damage or death to the intestinal tissue.
- Tumor and cancer of the small intestine
How Much Small Intestine Can Be "Lost"?
The small intestine is approximately 20-feet long and in most
cases, short bowel syndrome does not appear until it is only 6
feet in length. This means that a person can lose up to about
70% of his small intestine without becoming malnourished.
The lining of the small intestine is covered with millions of
finger-like projections called villi. These projections
provide a large surface area to absorb nutrients. In a process
called intestinal adaptation, when a portion
of the small intestine is surgically removed, villi from the remaining
part grow larger to compensate for the lost organ. Peristalsis,
or the movement of the food through the small intestine, is also
slowed to give the bowel more time to absorb nutrients.
Treatment for Short Bowel Syndrome?
short bowel syndrome treatments include:
- Diarrhea medicine
In cases of severe diarrhea, intravenous hydration may be required
to prevent dehydration.
- Vitamin, iron, folic acid, and protein supplements
To treat vitamin and nutrient deficiencies, your doctor may
prescribe water-soluble supplements that are easier to absorb.
- Lactase supplement
Because the small intestine produces the enzyme that digests
lactose, many short bowel syndrome patients
also have lactose
- Medications to reduce stomach acid
In patients with short bowel syndrome, acid-inhibiting peptides
normally present in the small intestine are missing. To reduce
the amount of stomach acid produced, your doctor may prescribe:
- Histamine or H2 receptor blocker
These medicines block the histamine receptors that signal
the stomach to make more acid.
- Proton pump inhibitors
These are drugs that directly disable the acid pumps in
Some prescription-strength antacids coat the stomach and
promote healing of lesions caused by peptic ulcer.
- Medications to bind bile-salt
- Surgery, including small intestine
Short bowel syndrome caused by intestinal bypass surgery can
usually be reversed by further surgery.
In rare cases, small intestine or small bowel transplant may
be required. This procedure has mixed success, and carries with
it the risk of organ rejection and infection.