Short bowel syndrome

Typically presents as a complication of extensive bowel resection.

The intestine adapts over time to be more efficient at nutrient absorption; the extent of adaptation determines the extent of recovery.

Treatment and prognosis are dependent on the length, health, and location of remaining bowel.

Management includes electrolyte and fluid replacement, provision of adequate macronutrients, and prevention and treatment of micronutrient deficiencies during intestinal adaptation.

Primary anastomosis of residual small bowel to colon, when possible, is the most important surgical procedure to reduce the need for parenteral nutrition (PN).

There should be an awareness of the possibility for medication malabsorption.

Physicians and patients need to watch closely for signs of dehydration, micronutrient deficiency, liver disease, and PN-related complications such as catheter infections and occlusions.

Short bowel syndrome (SBS) refers to a condition wherein substantial portions of the small intestine are absent, either congenitally or due to resection. This results in a loss of surface area for fluid, nutrient, and medication absorption, causing an inability to maintain protein-energy, fluid, electrolyte, or micronutrient balance when ingesting a conventionally accepted, normal diet.[1]O'Keefe SJ, Buchman AL, Fishbein TM, et al. Short bowel syndrome and intestinal failure: consensus definitions and overview. Clin Gastroenterol Hepatol. 2006 Jan;4(1):6-10. http://www.ncbi.nlm.nih.gov/pubmed/16431298?tool=bestpractice.com