Short bowel syndrome

Overview

Short bowel syndrome is a condition in which the small intestine cannot take in enough nutrients from foods because it's shorter than a typical small intestine or because its ability to absorb nutrients is decreased.

One role of the small intestine, also called the small bowel, is to absorb nutrients and fluids from food. The nutrients then circulate through the bloodstream. A short bowel may not be able to absorb enough nutrients for the body's needs.

Short bowel syndrome can happen when:

• A part of the small intestine is removed during surgery to treat another condition.
• The small intestine is shorter than typical at birth or has some other nontypical form.

Treatment of short bowel syndrome usually involves getting nutrition through a tube placed in a vein or through a feeding tube to the stomach. The condition also may be managed with a special diet and nutritional supplements. In some cases, surgery is needed.

Short bowel syndrome also is called short gut syndrome.

Symptoms

Common signs and symptoms of short bowel syndrome may include:

• Diarrhea.
• Greasy, foul-smelling stools.
• Extreme tiredness.
• Weight loss.
• Not enough nutrition from foods, also called malnutrition.
• Slower growth and development than expected in infants and children.

Short bowel syndrome also may cause low fluid levels, called dehydration. Symptoms of dehydration include:

• Dark-colored urine.
• Extreme thirst or dry mouth.
• Tiredness, lightheadedness or fainting.
• Sunken eyes or cheeks.
• Dry diapers for three or more hours.
• Crying without tears in children.

Causes

Several conditions of the small intestine are treated by surgery to remove damaged or diseased tissues. These conditions include:

• Necrotizing enterocolitis, a condition affecting newborns that causes the inflammation and death of intestinal tissues.
• Volvulus, twisting of the small intestine around itself.
• Crohn's disease, a long-term condition of the intestines that damages tissues of the small intestine and affects how it works.
• Cancer of the small intestine or radiation treatment for cancer.
• Mesenteric ischemia, a condition that cuts off or limits the blood supply to the small intestine.
• Traumatic injury to the belly.

A shortened small intestine after surgery may not be able to absorb enough nutrients and fluids. The type and amount of nutrition loss depend on how much of the small intestine was removed and what section was removed.

Conditions present at birth

Some conditions present at birth result in an infant not having a fully working small intestine. These include:

• A small intestine that's not as long as is typical at birth.
• Gastroschisis, a condition where part of the small intestine is outside of the skin of the belly.
• Intestinal atresia, a condition where some part of the small intestine is not completely formed.

Risk factors

Risk factors for short bowel syndrome include the following:

• Surgery to remove part of the small intestine to treat another medical condition increases the risk of short bowel syndrome.
• Premature birth and very low birth weight increase the risk of a small intestine that is not fully developed or has a condition that requires surgery to remove part of the bowel.

Complications

A lack of essential vitamins and minerals can cause many complications:

• Low amounts of oxygen-rich red blood cells.
• Bone diseases or weak, fragile bones.
• Delayed growth and development of children.
• Other conditions caused by vitamin deficiencies.

Long-term complications can include:

• Frequent diarrhea.
• Dehydration.
• Food allergies and intolerance in children.
• Overgrowth of bacteria in the small intestine.
• Liver disease.
• Gallstones.
• Kidney stones and poor kidney function.
• Ulcers of the stomach and the tube from the mouth to the stomach, called the esophagus.
• Malnutrition.
• Lack of expected growth and development in infants or children.
• Complications related to IV lines and feeding tubes used for nutrition.