Our Summary

Short bowel syndrome (SBS) is a rare condition where the body doesn’t absorb nutrients properly because part of the small intestine is missing or has been surgically removed. Other causes can include issues with blood vessels, tumors, or inflammatory bowel disease. The severity of the condition can vary a lot, depending on how much of the small intestine is left and how well it works.

Over the past few years, the way we care for people with SBS has gotten a lot better, greatly improving their quality of life and their chances of survival. This is mostly down to improvements in parenteral nutrition, a treatment that delivers nutrients directly into the bloodstream at home.

In the past decade, new treatments have been developed, and we’ve gotten better at using them. One of these, a drug called teduglutide, has shown particularly promising results and has brought about a new way of managing SBS.

This paper reviews the current knowledge on SBS, including its causes, how it affects the body, and how it’s treated surgically (including procedures that lengthen the intestine and transplanting a new one) and medically. It focuses on recent advancements in these areas. Additionally, it provides new insights and approaches to dealing with complications of SBS, such as sepsis, clotting in the catheter, and liver disease related to intestinal failure.

FAQs

  1. What is Short Bowel Syndrome (SBS) and what causes it?
  2. What are the recent advances in the management of Short Bowel Syndrome (SBS)?
  3. What are some complications associated with Short Bowel Syndrome (SBS) and how are they addressed?

Doctor’s Tip

A helpful tip a doctor might tell a patient about bowel resection is to follow a healthy and balanced diet to support digestion and absorption of nutrients. This may include eating smaller, more frequent meals, staying hydrated, and incorporating fiber-rich foods. Additionally, it is important to work closely with a healthcare team to monitor nutritional status and make any necessary adjustments to the diet or supplement regimen. Regular follow-up appointments and communication with healthcare providers can help ensure optimal recovery and long-term health after bowel resection surgery.

Suitable For

Patients who are typically recommended for bowel resection include those with short bowel syndrome (SBS) as a result of surgical resection of the small intestine, vascular diseases, neoplasms, or inflammatory bowel disease. These patients may experience malabsorption issues and may require surgical intervention to improve their quality of life and survival. Other treatment strategies, such as home-based parenteral nutrition (PN) and new drugs like teduglutide, have also shown promise in managing SBS complications. Intestinal lengthening procedures and intestinal transplantation may also be considered for some patients with SBS.

Timeline

  • Before bowel resection: The patient may experience symptoms such as abdominal pain, bloating, diarrhea, weight loss, and malnutrition. They may undergo various diagnostic tests such as imaging studies and blood tests to determine the underlying cause of their symptoms. Once it is determined that a bowel resection is necessary, the patient will undergo pre-operative preparation which may include fasting, bowel cleansing, and consultation with a surgeon and anesthesiologist.

  • During bowel resection: The patient will undergo surgery to remove the diseased portion of the bowel. The surgeon will carefully remove the affected area and reattach the healthy ends of the intestine. The patient will be closely monitored during and after the procedure for any complications.

  • After bowel resection: The patient will be monitored in the hospital for a period of time to ensure that they are recovering well from the surgery. They may experience pain, discomfort, and changes in bowel habits as they recover. The medical team will work with the patient to gradually reintroduce food and monitor their nutritional status. In some cases, the patient may require temporary or permanent use of home-based parenteral nutrition (HPN) to support their nutritional needs. Long-term follow-up care will be necessary to monitor for complications such as malabsorption, intestinal failure, and other related issues.

What to Ask Your Doctor

  1. What is bowel resection and why is it necessary for my condition?
  2. What are the potential risks and complications associated with bowel resection surgery?
  3. How long is the recovery period after bowel resection surgery?
  4. Will I need to make any changes to my diet or lifestyle after the surgery?
  5. Will I need to take any medications or supplements after bowel resection surgery?
  6. What follow-up care will be needed after the surgery?
  7. Are there any alternative treatments or procedures that could be considered instead of bowel resection?
  8. How will bowel resection surgery impact my overall quality of life?
  9. What are the chances of experiencing short bowel syndrome or other complications after bowel resection surgery?
  10. Are there any support groups or resources available for patients who have undergone bowel resection surgery?

Reference

Authors: Massironi S, Cavalcoli F, Rausa E, Invernizzi P, Braga M, Vecchi M. Journal: Dig Liver Dis. 2020 Mar;52(3):253-261. doi: 10.1016/j.dld.2019.11.013. Epub 2019 Dec 28. PMID: 31892505