Table of Contents
Short Bowel Syndrome Definition
Reduction in the structural or functional length of the SMALL INTESTINE that results in MALABSORPTION, chronic DIARRHEA, and other disturbances of digestion. MALNUTRITION is a common consequence. Short bowel syndrome most often results from surgery that removes segments of the small intestine as treatment for Crohn’s disease, DIVERTICULAR DISEASE, cancers of the small intestine, traumatic injury, and other conditions that irreparably damage the small intestine.
Short bowel syndrome was a common complication of a weight loss operation, jejunoileal bypass, that surgeons no longer perform. Functional short bowel syndrome also may develop following severe COLITIS (such as may occur with ESCHERICHIA COLI O157:H7 INFECTION) or radiation GASTROENTERITIS.
Short Bowel Syndrome Treatment
Treatment options for short bowel syndrome attempt to manage symptoms such as diarrhea as well as to meet NUTRITIONAL NEEDS. Most people who develop short bowel syndrome require PARENTERAL NUTRITION, a form of long-term intravenous feeding. Surgical options include operations to extend the remaining small intestine through various procedures and SMALL BOWEL TRANSPLANTATION or multivisceral transplantation (typically small bowel and LIVER or small bowel, liver, STOMACH, and PANCREAS). The extensive presence of lymphatic tissue in the gastrointestinal tract creates IMMUNE RESPONSE challenges with transplantation.
Liver and biliary dysfunctions (notably CHOLESTASIS) are common complications of short bowel syndrome, as the JEJUNUM and ILEUM produce a number of DIGESTIVE HORMONES that help to regulate liver activity and BILE release. When these segments of the small intestine are missing or no longer functional, the body has no secondary systems to synthesize these hormones. Long-term total parenteral nutrition exacerbates liver and biliary dysfunctions. These factors tend to lead to LIVER FAILURE. Research directions for solutions to the challenges of short bowel syndrome therapies include explorations in IMMUNOTHERAPY (with a focus on suppressing the immune response in transplantation), pharmacotherapy (with a focus on supplemental hormones), and surgical methods that might improve small bowel function without transplantation.