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Short Bowel Syndrome National Digestive Diseases Information Clearinghouse What is Short Bowel jejunum—the middle section of the small Syndrome intestine, where carbohydrates, proteins, fat, Short bowel syndrome is a group of problems and most vitamins are absorbed related to poor absorption of nutrients. Short ileum—the lower end of the small intestine, bowel syndrome typically occurs in people where bile acids and vitamin B12 are who have absorbed had at least half of their small intestine What is the large intestine? removed and sometimes all or part of The large intestine is about 5 feet long in their large intestine removed adults and absorbs water and any remaining significant damage of the small intestine nutrients from partially digested food passed poor motility, or movement, inside the from the small intestine. The large intestine intestines then changes waste from liquid to a solid matter called stool. Short bowel syndrome may be mild, moderate, or severe, depending on how well the small intestine is working. People with short bowel syndrome cannot absorb enough water, vitamins, minerals, protein, fat, calories, and other nutrients from food. What nutrients the small intestine has trouble absorbing depends on which section of the small intestine has been damaged or removed. What is the small intestine? The small intestine is the tube-shaped organ between the stomach and large intestine. Most food digestion and nutrient absorption take place in the small intestine. The small intestine is about 20 feet long and includes the duodenum, jejunum, and ileum: duodenum—the first part of the small The small intestine is the tube-shaped organ intestine, where iron and other minerals are between the stomach and large intestine. absorbed What causes Short Bowel meconium ileus, which occurs when Syndrome? the meconium, a newborn’s first stool, The main cause of short bowel syndrome is thicker and stickier than normal and blocks the ileum is surgery to remove a portion of the small midgut volvulus, which occurs when intestine. This surgery can treat intestinal blood supply to the middle of the small diseases, injuries, or birth defects. intestine is completely cut off Some children are born with an abnormally omphalocele, which occurs when the short small intestine or with part of their intestines, liver, or other organs stick out bowel missing, which can cause short bowel through the navel, or belly button syndrome. In infants, short bowel syndrome most commonly occurs following surgery to Even if a person does not have surgery, treat necrotizing enterocolitis, a condition disease or injury can damage the small in which part of the tissue in the intestines is intestine. 1 destroyed. Short bowel syndrome may also occur How common is Short Bowel following surgery to treat conditions such as Syndrome? cancer and damage to the intestines Short bowel syndrome is a rare condition. caused by cancer treatment Each year, short bowel syndrome affects 1 Crohn’s disease, a disorder that causes about three out of every million people. inflammation, or swelling, and irritation What are the signs and of any part of the digestive tract gastroschisis, which occurs when the symptoms of Short Bowel intestines stick out of the body through Syndrome? one side of the umbilical cord The main symptom of short bowel syndrome internal hernia, which occurs when the is diarrhea—loose, watery stools. Diarrhea small intestine is displaced into pockets can lead to dehydration, malnutrition, in the abdominal lining and weight loss. Dehydration means the intestinal atresia, which occurs when body lacks enough fluid and electrolytes— chemicals in salts, including sodium, a part of the intestines doesn’t form potassium, and chloride—to work properly. completely Malnutrition is a condition that develops intestinal injury from loss of blood flow when the body does not get the right amount due to a blocked blood vessel of vitamins, minerals, and nutrients it intestinal injury from trauma needs to maintain healthy tissues and organ function. Loose stools contain more fluid intussusception, in which one section These and electrolytes than solid stools. of either the large or small intestine problems can be severe and can be life folds into itself, much like a collapsible threatening without proper treatment. telescope 1 Thompson JS, Rochling FA, Weseman RA, Mercer DF. Current management of short bowel syndrome. Current Problems in Surgery. 2012;49(2):52–115. 2 Short Bowel Syndrome Other signs and symptoms may include Seek Help for Signs or bloating Symptoms of Severe cramping Dehydration fatigue, or feeling tired People who have any signs or symptoms foul-smelling stool of severe dehydration should call or see a heartburn health care provider right away: excessive thirst too much gas dark-colored urine vomiting infrequent urination weakness lethargy, dizziness, or faintness People with short bowel syndrome are also more likely to develop food allergies and dry skin sensitivities, such as lactose intolerance. Lactose intolerance is a condition in which Infants and children are most likely people have digestive symptoms—such as to become dehydrated. Parents or bloating, diarrhea, and gas—after eating or caretakers should watch for the following signs and symptoms of dehydration: drinking milk or milk products. dry mouth and tongue Read more in Lactose Intolerance at www.digestive.niddk.nih.gov. lack of tears when crying infants with no wet diapers for 3 What are the complications hours or more of Short Bowel Syndrome? infants with a sunken soft spot The complications of short bowel syndrome unusually cranky or drowsy behavior may include sunken eyes or cheeks malnutrition fever peptic ulcers—sores on the lining of the stomach or duodenum caused by too If left untreated, severe dehydration can much gastric acid cause serious health problems: organ damage kidney stones—solid pieces of material that form in the kidneys shock—when low blood pressure small intestinal bacterial overgrowth—a prevents blood and oxygen from condition in which abnormally large getting to organs numbers of bacteria grow in the small coma—a sleeplike state in which a intestine person is not conscious 3 Short Bowel Syndrome How is Short Bowel Blood Tests A blood test involves drawing a patient’s Syndrome diagnosed? blood at a health care provider’s office or a A health care provider diagnoses short bowel commercial facility and sending the sample syndrome based on to a lab for analysis. Blood tests can show a medical and family history mineral and vitamin levels and measure a physical exam complete blood count. blood tests Fecal Fat Tests fecal fat tests A fecal fat test measures the body’s ability to break down and absorb fat. For this test, an x-ray of the small and large intestines a patient provides a stool sample at a health upper gastrointestinal (GI) series care provider’s office. The patient may also use a take-home test kit. The patient collects computerized tomography (CT) scan stool in plastic wrap that he or she lays over the toilet seat and places a sample into a Medical and Family History container. A patient can also use a special Taking a medical and family history may help tissue provided by the health care provider’s a health care provider diagnose short bowel office to collect the sample and place the syndrome. He or she will ask the patient tissue into the container. For children about symptoms and may request a history of wearing diapers, the parent or caretaker past operations. can line the diaper with plastic to collect the stool. The health care provider will send Physical Exam the sample to a lab for analysis. A fecal fat test can show how well the small intestine is A physical exam may help diagnose short working. bowel syndrome. During a physical exam, a health care provider usually X-ray examines a patient’s body, looking for An x-ray is a picture created by using muscle wasting or weight loss and signs radiation and recorded on film or on a of vitamin and mineral deficiencies computer. The amount of radiation used uses a stethoscope to listen to sounds in is small. An x-ray technician performs the the abdomen x-ray at a hospital or an outpatient center, and a radiologist—a doctor who specializes taps on specific areas of the patient’s in medical imaging—interprets the images. body An x-ray of the small intestine can show that the last segment of the large intestine is narrower than normal. Blocked stool causes the part of the intestine just before this narrow segment to stretch and bulge. 4 Short Bowel Syndrome
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