Short Bowel Syndrome: Causes, Symptoms, and Treatment

Short bowel syndrome (SBS) develops when a small portion of the intestine is missing, either at birth or as a result of surgery. In this article, we will understand the symptoms, causes, complications, treatment and prevention of short bowel syndrome.

What is short bowel syndrome?

Short bowel syndrome is a condition where the small intestine is unable to absorb vitamins, minerals, and other nutrients from food. It is also known as "short gut syndrome" and "small bowel syndrome". It can be a result of the surgical shortening of the small intestine, a congenital defect, or damage to the intestine due to injury.

Symptoms of short bowel syndrome

The symptoms vary depending on the cause and the length of the short intestine.

Here are some of the common symptoms:

1. Diarrhea.

2. Malnutrition because the body cannot absorb enough minerals and vitamins from food.

3. Dehydration due to loose stool.

4. Stomach pain, bloating, and cramps. This happens due to improper absorption of food and gas generation.

5. Weakness and fatigue.

6. Vitamin and mineral deficiency.

7. Weight loss.

Causes of small bowel syndrome

Below are some causes of small bowel syndrome:

• Surgical removal of a part of the small intestine.

• Birth defects.

• Some diseases, such as necrotizing enterocolitis or radiation colitis, damage the small intestine.

• Gastroschisis is a birth defect of the intestinal walls. In this, the intestine comes outside the baby's body through the belly button. It can also result in smaller small intestines.

• Meconium ileus. It is a type of bowel blockage in newborns.

How to diagnose short bowel syndrome

Short bowel syndrome is diagnosed with a combination of medical, physical, and lab tests. These tests include:

1. Blood tests to check for malabsorption.

2. Stool tests to check for the presence of fat and other nutrients in the stool.

3. Imaging tests to check the length of the small intestine and assess its function.

4. Intestinal biopsy to look for damage to the structure of the intestine. This involves short bowel syndrome histology. A large amount of variation is seen in the cellular structure indicative of the condition.

5. Colonic transit study to check the movement of food through the digestive tract.

Treatment of Short Bowel Syndrome

The main concern of treatment of the syndrome is to manage malabsorption and promote the growth and function of the remaining small intestine.

Some common treatment options include:

Nutritional support: This is provided through a source outside the digestive tract. It can be either through the bloodstream or IV.

Medications: Some medications used for treatment include -

Prokinetics: helps the movement of food through the gut

Secretagogue: releases digestive juices

Anti-inflammatory drugs: to relieve the inflammation of the gut

Surgery: If a portion of the gut is not working properly it is removed to improve function. Intestinal transplantation is done for people with severe malabsorption or when other options have failed.

Lifestyle modification: Avoid high-fibre foods; eat small meals; and drink water after and not during meals.

Home parenteral nutrition: Some people may need IV support at home. This is called home parenteral nutrition.

Complications of Short Bowel Syndrome

The syndrome can lead to serious, even life-threatening, problems. Some complications include:

• Malabsorption of nutrition can lead to weakness and fatigue.

• Dehydration causes the loss of fluids from the body.

• Electrolyte imbalances can affect the functioning of other organs in the body.

• Liver dysfunction.

• Bacterial overgrowth. This can disrupt the normal balance of gut bacteria and lead to infections.

• Gallstones.

• Anaemia.

• Skin disorders like eczema and dermatitis.

It is important to closely monitor this condition with a healthcare professional.

How to prevent short bowel syndrome

Here are some ways to prevent the syndrome:

• Early diagnosis and treatment of conditions like IBS and colitis that lead to short bowel syndrome.

• Careful surgical planning and execution.

• Postoperative care is important after surgeries to prevent complications.

• A sufficient supply of nutrition must be maintained. A dietician can play a vital role in forming a good diet plan.

• Lifestyle modifications such as eating less fibrous food and eating small, more frequent meals.

• Use of medications as prescribed by the doctor.

FAQs

What is the life expectancy for people with short bowel syndrome?

It varies depending on the severity of the condition. In cases where the small intestine is partially removed and the remaining intestine is able to compensate for the loss, the life expectancy can be close to normal with good management. When a large portion of the small intestine is removed and the remaining intestine is not able to compensate, life expectancy is reduced.

Can you recover from short bowel syndrome?

Yes, recovery is possible if the remaining small intestine is able to function adequately. In more severe cases, recovery may not be possible, but the person can lead a relatively normal lifestyle through parenteral nutritional support.