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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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