Our Summary

The article reviews various treatments for Short Bowel Syndrome (SBS), a condition once considered a rapidly fatal medical event. Since the 1970s, home nutritional therapy has transformed SBS into a chronic but potentially manageable disease.

The paper discusses current treatments, which primarily include antidiarrheal drugs. These medicines are the standard treatment, despite there being little scientific evidence to show they are effective.

The article also talks about the promising role of certain hormones in the gut, specifically GLP-2 and its related compounds. These drugs help to reduce the major symptom of SBS - malabsorption, where the body is unable to properly absorb nutrients from food. These hormones are particularly applicable in cases where patients have lost a large portion of their intestine.

There are also surgical options like increasing the length of the intestine or transplanting it, but these are aggressive approaches and are only used in specific cases.

The authors conclude by highlighting the potential of GLP-2 related drugs as the first of a new group of treatments that can specifically target and potentially restore the lost absorption function in SBS patients. They believe these drugs could be a game-changer in treating severe intestinal loss and could become the standard treatment in the near future.

FAQs

  1. What is short bowel syndrome (SBS) and how has its treatment evolved over time?
  2. What are the current standard-of-care treatments for SBS and how effective are they?
  3. What is the potential of GLP-2 and its analogs in treating SBS, and who are the ideal candidates for this treatment?

Doctor’s Tip

One helpful tip a doctor might tell a patient about bowel resection is to follow a strict diet plan to help manage symptoms and ensure proper nutrition. This may include avoiding certain foods that can exacerbate diarrhea or cause discomfort, and focusing on a diet high in nutrients and easily digestible foods. Additionally, staying hydrated and taking any prescribed medications as directed can also help support recovery after bowel resection surgery.

Suitable For

Patients who are typically recommended bowel resection include those with short bowel syndrome, massive intestinal losses (fecal wet weight >1500 g/day), and severe intestinal insufficiency. These patients may require bowel resection due to conditions such as Crohn’s disease, intestinal obstructions, or other gastrointestinal disorders. In cases where pharmacological options and other non-surgical treatments have been ineffective, surgical options such as intestinal lengthening or transplantation may be considered. GLP-2 analogs are a promising option for alleviating malabsorption in patients with massive bowel resection and may become the therapeutic benchmark in the near future.

Timeline

Before bowel resection:

  • Patient may experience symptoms such as severe abdominal pain, bloating, diarrhea, and weight loss.
  • Diagnostic tests such as colonoscopy, CT scans, and blood tests may be performed to determine the need for surgery.
  • Patient may undergo pre-operative preparations such as bowel cleansing and dietary restrictions.
  • Patient may meet with a surgeon to discuss the procedure and potential risks.

After bowel resection:

  • Patient will be closely monitored in the hospital for complications such as infection, bleeding, or bowel obstructions.
  • Patient will be on a liquid diet initially and slowly transition to solid foods as tolerated.
  • Patient may need to use a temporary colostomy or ileostomy to allow the bowels to heal.
  • Patient will be given pain medications and antibiotics to prevent infection.
  • Patient will receive education on wound care, diet modifications, and possible long-term effects of the surgery.
  • Patient will have follow-up appointments with their surgeon to monitor healing and address any concerns.

What to Ask Your Doctor

  1. What is the reason for needing a bowel resection?
  2. What are the potential risks and complications of the surgery?
  3. How long is the recovery time after a bowel resection?
  4. Will I need a temporary or permanent colostomy or ileostomy?
  5. What dietary changes will I need to make after the surgery?
  6. What follow-up care will be needed after the surgery?
  7. Are there any alternative treatments or medications that could be considered instead of surgery?
  8. Will I need to take any medications after the surgery to manage symptoms or prevent complications?
  9. What is the long-term outlook for someone who has had a bowel resection?
  10. Are there any support groups or resources available for individuals who have had a bowel resection?

Reference

Authors: Hollanda Martins Da Rocha M, Lee ADW, Marin MLM, Faintuch S, Mishaly A, Faintuch J. Journal: Expert Opin Pharmacother. 2020 Apr;21(6):709-720. doi: 10.1080/14656566.2020.1724959. Epub 2020 Feb 14. PMID: 32057270