About Your Diagnosis

Short bowel syndrome is a malabsorption disorder that is a complication of extensive surgical resection of the small bowel. After surgery there is not enough bowel to absorb nutrients. If more than half of the bowel is removed during surgery, the risk of small bowel syndrome is great. Small bowel diseases that may require surgical intervention include Crohn’s disease and necrotizing enterocolitis in infants. The condition is detected by the patient’s history and an upper gastrointestinal (GI) barium x-ray study. On this study, the barium moves rapidly through the small bowel. The symptoms of short bowel syndrome may improve over time but will always require close attention to diet.

Living With Your Diagnosis
The key symptoms of short bowel syndrome are large amounts of foul-smelling diarrhea and weight loss. Crampy abdominal pains and weakness accompany the diarrhea and weight loss. The symptoms usually begin 3–10 days after abdominal surgery.

Treatment
The treatment for small bowel syndrome is nutritional support. Hospitalization may be required. The initial treatment commonly is intravenous hyperalimentation (TPN). This will allow the bowel to rest and recover somewhat. A histamine-2 (H2) blocker medication is given to help prevent the secretion of acid from the stomach. Usually after 1–4 weeks, the diarrhea will resolve and the appetite will return. At this time enteral feedings (mixtures put through a tube into the stomach) can resume. This is a slow process as the gut learns to work again. After weeks to months of this, you are able to slowly advance to oral feedings. Close monitoring of the diet will be key. A high-calorie, lowfat, low-residue diet is necessary. In some cases lifelong TPN is required. Supplementation of fatsoluble vitamins and minerals is also necessary.

The DOs
• If you have the condition, be patient. This condition takes months to slowly resolve.
• Be prepared for a long hospital stay. Many patients’ stays exceed 8 weeks.
• Once able to eat, watch the diet closely.
• Take vitamin and mineral supplements as prescribed.

The DON’Ts
• Avoid high-fat diets

When to Call Your Doctor
• If after bowel surgery you have diarrhea.
• If being treated for short bowel syndrome and the symptoms worsen or return.

Websites:
PedBase–Short Bowel Syndrome:
www.icondata.com/health/pedbase/files/SHORTBOW.HTM