Short Bowel Syndrome

Your bowels are made up of two parts the large intestine, also called the colon, and the small intestine. Short bowel syndrome usually affects people who’ve had a lot of their small intestine removed.

Causes

  • Adults usually have about 20 feet of small intestine. Those with short bowel syndrome usually have at least half of their small intestine missing or removed.

  • There are a lot of reasons why this might happen. Some babies are born with bowel problems that damage parts of the intestine. Others are just born with shorter bowels. Most often, short bowel syndrome happens after surgery to remove a large part of the small intestine.

Doctors may remove the small intestine as part of a treatment for:

  • Crohn’s disease, a lifelong inflammatory bowel disease that causes belly pain, diarrhea, and other digestive problems

  • Cancer

  • Damage from cancer treatment, like radiation therapy

  • Bowel injury

Symptoms

The main symptom of short bowel syndrome is diarrhea that doesn’t go away. You or your child may also have:

  • Cramping

  • Bloating

  • Gas

  • Heartburn

  • Weakness

  • Fatigue

  • Weight loss

Since your body has trouble getting nutrients and vitamins from food, it can also cause:

  • Anemia (not enough red blood cells)

  • Easy bruising

  • Fatty liver

  • Gallstones

  • Kidney stones

  • Bone pain and osteoporosis (thinning and fragile bones)

  • Trouble eating certain foods

Diagnosis

  • Blood tests

  • Stool exam

  • X-rays of your chest and belly

  • Upper GI series, also called a barium X-ray. You’ll drink a special liquid that coats your throat, stomach, and small intestine to make them stand out on the X-ray image.

  • CT scan, a powerful X-ray that makes detailed pictures inside your body

  • Ultrasound, which uses sound waves to make images of your organs

  • Bone density test

  • Liver biopsy, when doctors remove a piece of tissue for testing. Most of the time, doctors make a small cut on your belly and use a hollow needle to get the cells they need. They use a CT scan or an ultrasound to see where to place the needle. The biopsy takes about 5 minutes, but you may need a few hours to recover.

Precautions

  • Know what to eat - There’s no single diet plan for people with short bowel syndrome, but in general, you should make sure to eat lean protein (meat, dairy products, eggs, tofu) and carbs that are low in fiber (white rice, pasta, white bread). Avoid sweets and fat. A dietitian can help you figure out what foods are best.

  • Stay active - Exercise is good for your body and mind. Your doctor can tell you how much and what kinds of activity are right for you. If you’re using an IV for treatment, ask for one that you can carry with you.

  • Ask for help - Family, friends, and members of your community can help you run errands, get rides to the doctor, or just let you vent about the stresses of treatment. It may help to talk to a psychologist or counselor, too.

  • Learn from others - Support groups can be a great way to get advice and understanding from other people living with short bowel syndrome. Find a group that meets in your area, or explore online discussion boards.

Treatment

  • For mild cases, you may need to have several small meals a day, along with extra fluids, vitamins, and minerals. Your doctor will probably also give you medicine for diarrhea.

  • Treatment is the same for moderate cases, but from time to time, you may need extra fluids and minerals through an IV.

  • For more serious cases, you may get an IV feeding tube instead of eating meals. Or, you may have a tube placed directly into your stomach or small intestine. If your condition improves enough, you can stop the tube feedings.

  • In the most severe cases, people need IV feeding tubes all the time.

  • Your doctor may suggest surgery, including a transplant of part or all of your small intestine. A new organ can cure small bowel syndrome, but a transplant is major surgery.Doctors usually recommend it only when other treatments haven’t worked.

  • If you choose this option, your doctor will put you on a waiting list for a small intestine from a donor. After your transplant, you could be in the hospital for 6 weeks or longer. You’ll need to take drugs that prevent your body from rejecting your new organ. You’ll need the medicine and regular check-ups for the rest of your life.

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