What Is Short Bowel Syndrome? | Gastroenterology

Short Bowel Syndrome

Overview of short bowel syndrome

Short bowel syndrome (SBS) generally affects people who have had their small intestine removed. Your intestines are made up of two parts: the large intestine and also the small intestine.  Without this component, your body will not get enough nutrients and water from the food you eat. It can cause intestinal problems like diarrhoea, which can be dangerous if left untreated.

Causes of short bowel syndrome

Adults typically have 20 feet of the small intestine. People with a small intestine syndrome or short bowel syndrome usually lose or have at least half of the small intestine removed.

There are many reasons for this to happen. Some babies are born with intestinal problems that damage parts of the intestine. Others are born with a small intestine. Most often, the small intestine syndrome occurs after surgery to remove a large part of the small intestine.

As part of treatment, the doctor may remove the small intestine:

  • Lifelong inflammatory bowel disease causing Crohn’s disease, abdominal pain, diarrhoea, and other digestive problems.
  • Cancer
  • Damages caused by cancer treatment, such as radiation therapy
  • Intestinal injury.

Symptoms of short bowel syndrome

The main symptom of short bowel syndrome is diarrhoea, which does not go away. You or your child can also:

  • Numbness
  • Swelling
  • Gas
  • Acidity
  • Weakness
  • Fatigue
  • Weightloss

This may also be because your body has a hard time getting nutrients and vitamins from your diet:

  • Anaemia (insufficient red blood cells)
  • Easily injured
  • Fatty liver
  • Gallstones
  • Kidney stones
  • Bone pain and osteoporosis (weakened and brittle bones)
  • Difficulty eating certain foods.

Diagnosis of short bowel syndrome

If you have any symptoms and your small intestine is removed, your doctor may already suspect small intestine syndrome. The doctor does a physical exam and may do other tests:

  • Blood test
  • Stool test
  • X-rays of your chest and abdomen
  • Upper GI series, also known as a barium radiograph. Drink a special liquid to hold the throat, stomach, and small intestine in the X-ray image.
  • CT scan, a powerful X-ray that generates detailed images inside your body.
  • Ultrasound, which uses sound waves to create images of your organs.
  • Bone density test

In addition to the tests, your doctor will also ask you questions about your symptoms:

  • How did you feel?
  • When did your symptoms start?
  • Do you have any other medical conditions?
  • How are your energy levels?
  • Do you have diarrhoea?
  • Do you have problems eating certain foods?

Treatment for short bowel syndrome

The treatment has two goals: to reduce symptoms and provide you with enough vitamins and minerals. The treatment you receive depends on the severity of your condition.

  • In mild cases, you may need to prepare a very small meal a day along with extra fluids, vitamins, and minerals. Your doctor may also give you medicine for diarrhoea.
  • Treatment is the same for moderate cases, but from time to time, you may need extra fluids and minerals through an IV.
  • In more severe cases, you may receive an IV feeding tube instead of eating. Or you can put a tube directly into your stomach or small intestine. If your condition improves enough, you can stop tube feeding.
  • In the most severe cases, people need IV feeding tubes at all times.

Your doctor may prescribe surgery, which includes part or all of the small intestine transplant. A new organ can cure the small intestine syndrome, but transplantation is a bigger surgery. Doctors generally recommend it only when other treatments don’t work.

If you choose this option, your doctor will put you on a waiting list for a donor small intestine. After your transplant, you may be hospitalized for 6 weeks or more. You need to take a medicine that keeps your body from rejecting your new organ. You will need medications and regular checkups for the rest of your life.

Depending on your condition, other treatments can help your small intestine absorb more nutrients and water. Among them are:

  • Teduglutide (Gottex). Doctors may prescribe this hormone to adults with severe cases of small bowel syndrome who require intravenous feeding tubes.
  • L-Glutamine, which you can mix with water and drink. Helps the small intestine absorb more nutrients, studies have shown.
  • Somatropin (Zorbtive), a human growth hormone. You will find this medicine in the injection. This can help your intestines function on their own, so you don’t need a lot of nutritional support.

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