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What Is Short Bowel Syndrome? Causes, Symptoms, Complications And Treatments

Short bowel syndrome, also known as short gut syndrome, is a challenging and complex medical condition in which a patient has less than 180-200 centimetres of bowel length, leading to poor absorption of fluid supplements and nutrients like vitamins, minerals, fats and trace elements. [1]

The usual length of the small bowel in an adult is between 275 and 850 millimetres. Oral fluids, saliva, gastric, biliary and pancreatic secretions travel through the small bowel totalling about nine litres. The small colon absorbs roughly seven litres of these fluids while the big gut absorbs two litres. Also, most of the nutrients are absorbed in the first 100 centimetres of the jejunum, and others like B12, bile salts and magnesium are absorbed in the last 100 cm of the ileum.

Short bowel, due to various factors like surgery or damage to the small intestine, can be mild, moderate or severe, depending on the functionality of the organ.

Here, we will discuss short bowel syndrome in detail. Take a look.

What Are Small And Large Intestines?

The small intestine is a tube-shaped structure located between the stomach and the large intestine. It is the organ where most of the digestion and absorption of nutrients takes place. The duodenum, jejunum, and ileum are all part of the small intestine, which is around 20 feet long. [2]

The duodenum is the first section of the small intestine, which absorbs iron and other minerals. The jejunum is the middle portion that absorbs carbs, proteins, fats and most vitamins. The ileum is the last section that absorbs bile acids and vitamin B12.

In adults, the large intestine is around five feet long and absorbs water as well as any residual nutrients from partially digested food that passes through the small intestine. The large intestine then converts the waste from liquid to solid faeces.

Causes Of Short Bowel Syndrome

The most common cause of the short bowel syndrome is surgery to remove a section of the small intestine, probably due to conditions like intestinal disorders, traumas, and congenital deformities.

Short gut syndrome is present in children who are born with an abnormally short small intestine or a missing portion of their colon. The condition is frequent in babies after surgery to treat necrotizing enterocolitis, a disorder in which a portion of the gut tissue is destroyed.

Short bowel syndrome developed as a result of surgery could be due to: [3]

  • cancer and its treatment.
  • Internal hernia or when the small intestine is pushed into pockets in the abdominal lining.
  • Crohn's disease.
  • Intestinal atresia, a condition in which a portion of the intestine does not fully develop.
  • Traumatic damage to the intestine.
  • Injury to the intestine due to loss of blood flow as a result of a blocked blood artery.
  • Intussusception, in which one section of either the large or small intestine folds into itself.

Symptoms Of Short Bowel Syndrome

Some of the symptoms of short bowel syndrome may include: [4]

  • Diarrhoea
  • Malnutrition and weight loss due to diarrhoea.
  • Bloating
  • Stomach pain.
  • Foul-smelling stool.
  • Fatigue
  • Vomiting
  • Flatulence
  • Weakness

Complications Of Short Bowel Syndrome

Untreated short bowel syndrome can lead to complications like:

  • Food sensitivities and allergies like lactose intolerance. [5]
  • Malnutrition.
  • Kidney stones [6]
  • Peptic ulcers.
  • Bacterial infection in small infection.

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Diagnosis Of Short Bowel Syndrome

A medical expert may ask for the medical and family history of a patient, followed by:

  • Physical examination: To look for symptoms like weight loss.
  • Blood tests: to measure nutrient count.
  • X-ray of the gut: To look for problems in the intestines.
  • Faecal fat test: To measure the ability of the body to absorb fat.

Treatments Of Short Bowel Syndrome

Some of the treatment methods for short bowel syndrome may include:

  • Medicines: It includes medications like antibiotics to prevent bacterial infection; bile-salt binders to lower the frequency of diarrhoea; H2 blockers to lower secretion of gastric acid and others like teduglutide to improve intestinal absorption. [7]
  • Nutritional support: It includes oral rehydration and nutrient supplements.
  • Surgery: To treat blockage or narrowing of the small intestine. Long term treatment includes the removal of a portion of the intestine and supportive therapies to look for the functions of the remaining portion and nutritional absorption.
  • Intestinal transplant: It includes removal of the injured intestinal portion and replacing it with a healthy one.

To Conclude

Short gut syndrome is a life-long condition and must be managed effectively to avoid any complications and improve the quality of life.

Story first published: Monday, May 16, 2022, 16:30 [IST]
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