Short bowel syndrome
Short bowel syndrome is a condition that occurs when part of the small intestine is missing or has been removed during surgery. Nutrients are not properly absorbed into the body (malabsorption
) as a result.
Small intestine insufficiency
When part of the small intestine is missing, there may not be enough surface area in the bowel to absorb enough nutrients from food. The this can happen when half or more of the bowel is removed during surgery or sections are missing due to a birth defect (congenital defect),
Risk factors include diseases of the small intestine that may require surgery, such as Crohn's disease
. In infants, necrotizing enterocolitis
is a common cause.
Exams and Tests
- Blood chemistry tests (such as albumin level
- Complete blood count (CBC
- Fecal fat
- Small intestine x-ray
- Vitamin levels in the blood
Treatment is aimed at relieving symptoms. Treatments may include:
- A high-calorie diet that supplies key vitamins and minerals, as well as carbohydrates, proteins, and fats
- Injections of some vitamins and minerals
- Vitamin B12
, folic acid
and increased iron in the diet
to treat anemia
- Medicines to slow down the normal movement of the intestine so food remains in the intestine longer
- Injections of special growth factors
- Tube feeding through a vein (parenteral nutrition) if normal feeding is not supplying enough nutrients
- Small bowel transplantation in some cases
The condition may improve over time if it is due to surgery. Nutrient absorption may slowly get better.
- Bacterial overgrowth in the small intestine
- Nervous system problems caused by a lack of vitamin B12
- Too much acid in the blood (metabolic acidosis
due to diarrhea)
- Kidney stones
- Weakened bones (osteomalacia)
- Weight loss
When to Contact a Medical Professional
Call your health care provider if you develop symptoms of short bowel syndrome, especially after you have had bowel surgery.
Semrad CE. Approach to the patient with diarrhea and malabsorption. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 142.
Jenifer K. Lehrer, MD, Department of Gastroenterology, Frankford-Torresdale Hospital, Aria Health System, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.