Table of ContentsView AllTable of ContentsWhat Is SBS?CausesSymptomsDiagnosisTreatmentLifestyle ChangesComplicationsOutlook
Table of ContentsView All
View All
Table of Contents
What Is SBS?
Causes
Symptoms
Diagnosis
Treatment
Lifestyle Changes
Complications
Outlook
Short bowel syndrome (SBS), which is also called short gut syndrome, is when the small intestine is not absorbing the right amounts of nutrients and fluids. It can happen because too much of the small intestine is missing or because it is not working as well as it should.
Treatments for short bowel syndrome include medication, changes to diet, and surgery. SBS may be a permanent or a temporary condition.This article will discuss the symptoms and treatment of SBS, including medication and surgery used to treat the condition.
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What Is Short Bowel Syndrome (SBS)?
The purpose of thesmall intestineis to break down food and absorb vitamins, minerals, sugars, amino acids (the building blocks of protein), and fatty acids. The small intestine is like a tube. It is about 20 feet long in adults. It is located in the abdomen and runs between the stomach and the large intestine.
Food is chewed and swallowed, then travels down theesophagusto the stomach. After it leaves the stomach, it passes through to the small intestine, where food is broken down; vitamins, minerals, and nutrients are taken up; and water is extracted to solidify food wastes. The waste then passes to thecolon, where more water is absorbed, and then it is passed out of the body as stool.
When the small bowel is shortened, it could lead to fewer vitamins and minerals being absorbed. The small intestine has different sections, each of which absorbs different nutrients. If one or more sections are missing or shorter than usual, they may not be able to absorb enough vitamins. This could lead to SBS.
SBS has different definitions, but one commonly used is when someone has less than 200 centimeters (cm)—equal to about 79 inches or 6.5 feet—of small bowel. A child with SBS will usually have less than 25% of the length of a typical small bowel for their age.
However, SBS could also occur in someone with more than 200 cm of bowel. This can happen if the bowel that is there isn’t absorbing nutrients well or is moving food through too quickly to absorb well. This is called functional SBS.
What Causes Short Bowel Syndrome?
In most cases, SBS occurs after there have been one or more surgeries on the small intestine. Surgery on the small bowel could be done to treatinflammatory bowel disease (IBD),cancer, or an injury.
There are a few other causes of SBS that are found in children. These include:
Short Bowel Syndrome Symptoms
The symptoms of SBS can include:
In people with anostomy(surgery to create an opening in the abdomen through which stool can exit the body), a high output stoma—that is more than 1,500 milliliters (mL) per day, or about 6 cups of stool for three to five days—may also lead to symptoms of SBS.
What’s Wrong with My Stomach?
How Is Short Bowel Syndrome Diagnosed?
There’s not just one, single test that can help provide a diagnosis of SBS. Getting a diagnosis is a process that takes into consideration your health history, your history of surgeries, and your symptoms.
A combination of tests can help diagnose SBS, including:
How Is Short Bowel Syndrome Treated?
SBS has three phases. An acute phase happens directly after the causative event (such as surgery). Then there is an adaptation phase where the body may learn to absorb more nutrients and water, which could last up to two years.
Third is the chronic phase. In about half of people with SBS, the condition doesn’t reverse or improve enough to go without treatment. They may continue to need intravenous (IV) nutrition for a time.
About 48% of people diagnosed with SBS still need to receive nutrition via an IV after five years.
A variety of treatments might be used or needed for SBS.
Diet and Nutrition
Parenteralnutritionis when nutrients, vitamins, minerals, and fluids are given through an IV. The IV might be placed in the arm or neck, or through acentral veinunder the collarbone. It might be used for either the short-term or the long-term.
In the short term, parenteral nutrition might be started directly after having surgery on the bowel. Some people with chronic SBS may need parenteral nutrition at home.
Enteralnutrition may also be used to get nutrients. It is given through a tube inserted into the stomach or the small intestine. The tube could be placed down through the nose for temporary use or through the abdomen for long-term use. It may be referred to as afeeding tube.
Meeting With a DietitianPeople with SBS should have access to a nutrition specialist, such as a dietitian. Even one appointment can help people understand how best to support their nutrition while living with SBS. In some cases, regular appointments will be needed because nutrient needs will change as the SBS moves out of the acute phase.
Meeting With a Dietitian
People with SBS should have access to a nutrition specialist, such as a dietitian. Even one appointment can help people understand how best to support their nutrition while living with SBS. In some cases, regular appointments will be needed because nutrient needs will change as the SBS moves out of the acute phase.
Medication
Treating SBS includes ensuring nutrition is being managed and symptoms are treated.
Some of the medications that might be used include:
The effects of SBS could cause other issues, and some medications might be needed to treat those, as well. Treatment is individualized because each person with SBS will have different conditions and concerns. Some of the other drugs that might be used include:
Surgery
Surgery may lead to SBS, but it also might be necessary as a treatment. Various types of surgery might be used.
Autologous intestinal reconstruction surgery (AIRS) may be used in SBS. It can be performed in several ways. The goal is to increase the length of the small intestine and improve absorption.
Intestinal transplantation is another surgical option. This is when the small intestine and possibly other digestive organs are replaced. It is generally reserved for people who have life-threatening SBS.
Intestinal transplants are still uncommon and can cause complications. However, technique and five-year survival rates are improving.
Lifestyle Changes
SBS is a complex condition. It is important to work closely with the healthcare team, which may include many members. Ask questions and be open about how SBS affects all aspects of your life. It may be difficult or even embarrassing at times, but being honest could help improve care.
While coping with SBS, there may be times when it is necessary to lean on others for help and support. This can include family, friends, and the healthcare team. Asking for and accepting help in everything from getting to and from medical appointments to grocery shopping is important.
Connecting with a patient support group is also useful. SBS is a rare condition, so it’s unlikely that you will know anyone else who is living with it. Meeting people with SBS and their families, virtually or in person, will help with stress and learning tips for day-to-day management.
Working with a mental health professional may be helpful for people with SBS, as well. Counseling may be temporary or continue long term. It’s important for people with SBS and their families to get help in coping with the ups and downs of the condition.
What Complications May Develop From Short Bowel Syndrome?
The complications of SBS can include those that are from the condition as well as from needing nutritional care. They can include:
What Is the Outlook for Short Bowel Syndrome?
Unfortunately, there is no cure for SBS. However, the management of SBS has improved in recent years. Various treatments can help people live better lives while managing the condition.
Many people with SBS don’t need parenteral nutrition, or they only need it for about a year. For those with a shorter intestine, parenteral nutrition might be needed for the long term.
The outlook for SBS is going to be different based on several factors. For that reason, it’s difficult to broadly predict outcomes. People with SBS should work with their healthcare providers to understand the potential for complications and their prognosis.
Summary
SBS is a complex condition. It may occur after surgery or treatment for cancer. SBS may be temporary, meaning that it could be a problem that lasts for a number of months or even years. The body may adapt over time, and treatment might no longer be needed. In some cases, SBS may turn into a chronic condition that needs management.
Treating SBS includes managing nutrition with the help of the healthcare team and optimally, a dietitian. SBS may lead to other health problems, so some treatments may be used to try to prevent complications such as liver disease.
A team of healthcare providers will be needed to manage all the aspects of SBS. The prognosis for SBS is mixed, and will depend on the severity of the disease and overall health.
11 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Massironi S, Cavalcoli F, Rausa E, Invernizzi P, Braga M, Vecchi M.Understanding short bowel syndrome: current status and future perspectives.Digestive and Liver Disease. 2020;52:253-261. doi:10.1016/j.dld.2019.11.013Pironi L.Definition, classification, and causes of short bowel syndrome.Nutr Clin Pract. 2023;38 Suppl 1:S9-S16. doi:10.1002/ncp.10955.National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of short bowel syndrome.Lezo A, Diamanti A, Marinier EM, et al.Chronic intestinal failure in children: An international multicenter cross-sectional survey.Nutrients. 2022;14:1889. doi:10.3390/nu14091889Bielawska B, Allard JP.Parenteral nutrition and intestinal failure.Nutrients. 2017;9:466. doi:10.3390/nu9050466.National Institute of Diabetes and Digestive and Kidney Diseases.Treatment of short bowel syndrome.Pironi L, Allard JP, Joly F, Geransar P, Genestin E, Pape UF.Use of teduglutide in adults with short bowel syndrome-associated intestinal failure.Nutr Clin Pract. 2023;10.1002/ncp.11015. doi:10.1002/ncp.11015Boroni G, Parolini F, Stern MV, Moglia C, Alberti D.Autologous intestinal reconstruction surgery in short bowel syndrome: which, when, and why.Front Nutr. 2022;9:861093. doi:10.3389/fnut.2022.861093Billiauws L, Maggiori L, Joly F, Panis Y.Medical and surgical management of short bowel syndrome.J Visc Surg. 2018;155:283-291. doi:10.1016/j.jviscsurg.2017.12.012Hernández Oliveros F, Alcolea Sánchez A, Ramos Boluda E, Andrés Moreno A.Intestinal and multivisceral transplantation. Trasplante intestinal y multivisceral.Cir Pediatr. 2023;36:50-59. doi:10.54847/cp.2023.02.11Short Bowel Syndrome Foundation.Management of care.Additional ReadingCaregiver Action Network.Short Bowel Syndrome Foundation.National Organization for Rare Disorders.Short Bowel Syndrome. Updated Feb 1, 2021.
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Massironi S, Cavalcoli F, Rausa E, Invernizzi P, Braga M, Vecchi M.Understanding short bowel syndrome: current status and future perspectives.Digestive and Liver Disease. 2020;52:253-261. doi:10.1016/j.dld.2019.11.013Pironi L.Definition, classification, and causes of short bowel syndrome.Nutr Clin Pract. 2023;38 Suppl 1:S9-S16. doi:10.1002/ncp.10955.National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of short bowel syndrome.Lezo A, Diamanti A, Marinier EM, et al.Chronic intestinal failure in children: An international multicenter cross-sectional survey.Nutrients. 2022;14:1889. doi:10.3390/nu14091889Bielawska B, Allard JP.Parenteral nutrition and intestinal failure.Nutrients. 2017;9:466. doi:10.3390/nu9050466.National Institute of Diabetes and Digestive and Kidney Diseases.Treatment of short bowel syndrome.Pironi L, Allard JP, Joly F, Geransar P, Genestin E, Pape UF.Use of teduglutide in adults with short bowel syndrome-associated intestinal failure.Nutr Clin Pract. 2023;10.1002/ncp.11015. doi:10.1002/ncp.11015Boroni G, Parolini F, Stern MV, Moglia C, Alberti D.Autologous intestinal reconstruction surgery in short bowel syndrome: which, when, and why.Front Nutr. 2022;9:861093. doi:10.3389/fnut.2022.861093Billiauws L, Maggiori L, Joly F, Panis Y.Medical and surgical management of short bowel syndrome.J Visc Surg. 2018;155:283-291. doi:10.1016/j.jviscsurg.2017.12.012Hernández Oliveros F, Alcolea Sánchez A, Ramos Boluda E, Andrés Moreno A.Intestinal and multivisceral transplantation. Trasplante intestinal y multivisceral.Cir Pediatr. 2023;36:50-59. doi:10.54847/cp.2023.02.11Short Bowel Syndrome Foundation.Management of care.Additional ReadingCaregiver Action Network.Short Bowel Syndrome Foundation.National Organization for Rare Disorders.Short Bowel Syndrome. Updated Feb 1, 2021.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Massironi S, Cavalcoli F, Rausa E, Invernizzi P, Braga M, Vecchi M.Understanding short bowel syndrome: current status and future perspectives.Digestive and Liver Disease. 2020;52:253-261. doi:10.1016/j.dld.2019.11.013Pironi L.Definition, classification, and causes of short bowel syndrome.Nutr Clin Pract. 2023;38 Suppl 1:S9-S16. doi:10.1002/ncp.10955.National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of short bowel syndrome.Lezo A, Diamanti A, Marinier EM, et al.Chronic intestinal failure in children: An international multicenter cross-sectional survey.Nutrients. 2022;14:1889. doi:10.3390/nu14091889Bielawska B, Allard JP.Parenteral nutrition and intestinal failure.Nutrients. 2017;9:466. doi:10.3390/nu9050466.National Institute of Diabetes and Digestive and Kidney Diseases.Treatment of short bowel syndrome.Pironi L, Allard JP, Joly F, Geransar P, Genestin E, Pape UF.Use of teduglutide in adults with short bowel syndrome-associated intestinal failure.Nutr Clin Pract. 2023;10.1002/ncp.11015. doi:10.1002/ncp.11015Boroni G, Parolini F, Stern MV, Moglia C, Alberti D.Autologous intestinal reconstruction surgery in short bowel syndrome: which, when, and why.Front Nutr. 2022;9:861093. doi:10.3389/fnut.2022.861093Billiauws L, Maggiori L, Joly F, Panis Y.Medical and surgical management of short bowel syndrome.J Visc Surg. 2018;155:283-291. doi:10.1016/j.jviscsurg.2017.12.012Hernández Oliveros F, Alcolea Sánchez A, Ramos Boluda E, Andrés Moreno A.Intestinal and multivisceral transplantation. Trasplante intestinal y multivisceral.Cir Pediatr. 2023;36:50-59. doi:10.54847/cp.2023.02.11Short Bowel Syndrome Foundation.Management of care.
Massironi S, Cavalcoli F, Rausa E, Invernizzi P, Braga M, Vecchi M.Understanding short bowel syndrome: current status and future perspectives.Digestive and Liver Disease. 2020;52:253-261. doi:10.1016/j.dld.2019.11.013
Pironi L.Definition, classification, and causes of short bowel syndrome.Nutr Clin Pract. 2023;38 Suppl 1:S9-S16. doi:10.1002/ncp.10955.
National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of short bowel syndrome.
Lezo A, Diamanti A, Marinier EM, et al.Chronic intestinal failure in children: An international multicenter cross-sectional survey.Nutrients. 2022;14:1889. doi:10.3390/nu14091889
Bielawska B, Allard JP.Parenteral nutrition and intestinal failure.Nutrients. 2017;9:466. doi:10.3390/nu9050466.
National Institute of Diabetes and Digestive and Kidney Diseases.Treatment of short bowel syndrome.
Pironi L, Allard JP, Joly F, Geransar P, Genestin E, Pape UF.Use of teduglutide in adults with short bowel syndrome-associated intestinal failure.Nutr Clin Pract. 2023;10.1002/ncp.11015. doi:10.1002/ncp.11015
Boroni G, Parolini F, Stern MV, Moglia C, Alberti D.Autologous intestinal reconstruction surgery in short bowel syndrome: which, when, and why.Front Nutr. 2022;9:861093. doi:10.3389/fnut.2022.861093
Billiauws L, Maggiori L, Joly F, Panis Y.Medical and surgical management of short bowel syndrome.J Visc Surg. 2018;155:283-291. doi:10.1016/j.jviscsurg.2017.12.012
Hernández Oliveros F, Alcolea Sánchez A, Ramos Boluda E, Andrés Moreno A.Intestinal and multivisceral transplantation. Trasplante intestinal y multivisceral.Cir Pediatr. 2023;36:50-59. doi:10.54847/cp.2023.02.11
Short Bowel Syndrome Foundation.Management of care.
Caregiver Action Network.Short Bowel Syndrome Foundation.National Organization for Rare Disorders.Short Bowel Syndrome. Updated Feb 1, 2021.
Caregiver Action Network.
Short Bowel Syndrome Foundation.
National Organization for Rare Disorders.Short Bowel Syndrome. Updated Feb 1, 2021.
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