Short Bowel Syndrome

Diagnosis

The diagnosis of short bowel disease is based on a combination of a physical exam, laboratory tests and imaging exams. Tests results generally are available within hours in Mayo's state-of-the-art electronic medical record.

Medical History and Physical Examination

The first step in diagnosing and properly treating short bowel syndrome is an in-depth interview with the patient and a physical exam. During the interview, the gastroenterologist gathers details about the patient's conditions and surgical history. It is essential that patients bring all previous surgical reports for the physician to review during the evaluation.

Laboratory Tests - Complete blood count (CBC)

Doctors typically use a CBC to detect anemia in patients who are being evaluated for short bowel syndrome. The test measures the levels of white, red and hemoglobin cells in the blood.

Blood chemistry tests

These tests are performed on the portion of blood called serum. The tests evaluate electrolyte levels, and chemicals related to metabolism and other digestive functions.

Fecal fat test

This test measures the amount of fat released in a patient's feces, which indicates whether a patient is absorbing the amounts of dietary fat necessary for proper nutrition.

Imaging Studies

The following imaging studies may be used to determine details about a patient's condition.

• X-rays generate a two-dimensional view of the abdomen that helps physicians locate abnormalities in the small bowel, such as obstruction.
• Barium upper GI X-rays. Patients drink liquid containing barium, which coats the intestines and helps show abnormal structures or obstructions in the small bowel. Patients must abstain from food and beverages prior to the test.
• CT scans generate two-dimensional images of the abdomen that may reveal problems in the small intestine. New technology at Mayo Clinic enables 3-D reconstruction of CT images. A special study, called CT enterography, which uses an oral contrast dye to highlight changes in the small intestine, is also available at Mayo.

Endoscopy or Colonoscopy

Specialists can examine the interior of the duodenum, the upper part of the jejunum (proximal jejunum), and the lowest parts of the small intestine (terminal ileum) using an endoscope or colonoscope. For these procedures, physicians give patients a mild sedative before passing a thin tube containing a light source and camera down the throat and through the stomach (endoscopy), or up through the rectum (colonoscopy). Unfortunately, neither test reaches the entire small bowel.