Our Summary

Short bowel syndrome (SBS) is a condition where the intestines don’t function properly, to the extent that the person affected can’t absorb enough nutrients or water. This means they need to receive nutrients through a vein to stay healthy. Over time, the body can adapt to this condition in different ways, like producing more hormones, eating more, and changing the bacteria in the gut. This can help the person absorb more nutrients and rely less on intravenous feeding.

One treatment option for people with this condition is to use hormones to help the intestines adapt better. For example, studies have shown that a drug called teduglutide can help the body produce more urine and reduce the need for intravenous feeding. Current guidelines suggest that if a hormone treatment is being considered, teduglutide should be the first choice.

It’s important to monitor people with SBS at home and adapt their treatment as needed. This complex process is best managed with a team of different health professionals.

FAQs

  1. What is short bowel syndrome (SBS) and what is its main cause?
  2. What is teduglutide and how does it help patients with SBS and chronic intestinal failure?
  3. What is the importance of patient monitoring and multidisciplinary approach in managing SBS and chronic intestinal failure?

Doctor’s Tip

A helpful tip a doctor might tell a patient about intestinal resection is to follow a strict dietary plan to ensure adequate nutrient absorption and to prevent complications such as malnutrition. It is important to work closely with a healthcare team, including a dietitian, to develop a meal plan that meets your individual needs. Additionally, staying hydrated and avoiding foods that may irritate the intestines can help promote healing and improve overall digestive health. Regular follow-up appointments with your doctor are also important to monitor your progress and make any necessary adjustments to your treatment plan.

Suitable For

Patients with short bowel syndrome (SBS) and chronic intestinal failure (IF) are typically recommended for intestinal resection. These patients have reduced gut function below the minimum necessary for the absorption of nutrients and require intravenous supplementation to maintain health and/or growth. Intestinal resection can help improve intestinal absorption and decrease the dependency on parenteral nutrition. Hormonal treatments, such as teduglutide, can promote intestinal hyperadaptation and reduce the need for parenteral support volume in these patients. A multidisciplinary approach is recommended for the management of these patients, with close monitoring at home.

Timeline

  • Before intestinal resection: The patient may suffer from conditions such as bowel obstruction, Crohn’s disease, or colon cancer, which require surgical removal of a portion of the intestine. The patient undergoes preoperative evaluation and preparation for surgery.

  • During intestinal resection: The surgeon removes the affected portion of the intestine, leaving the remaining segments to be reconnected. The patient is monitored closely during and after the surgery for any complications.

  • After intestinal resection: The patient may experience symptoms such as diarrhea, malabsorption, weight loss, and nutritional deficiencies due to the reduced functional capacity of the remaining intestine. The patient may require parenteral nutrition (PN) to maintain adequate nutrition and hydration.

  • 2 years after resection: Spontaneous intestinal adaptation occurs, leading to increased hormonal secretion, development of hyperphagia, and gut microbiota dysbiosis. These changes improve intestinal absorption and decrease the dependency on PN.

  • Hormonal treatments: Patients with short bowel syndrome and chronic intestinal failure may benefit from hormonal treatments such as teduglutide, which promotes intestinal hyperadaptation and reduces the need for PN support volume.

  • Monitoring and multidisciplinary approach: Patient monitoring at home is crucial for managing short bowel syndrome and intestinal failure. A multidisciplinary approach involving healthcare professionals such as dietitians, gastroenterologists, and surgeons is essential for optimal patient care and management.

What to Ask Your Doctor

  1. What is the reason for recommending an intestinal resection?
  2. What are the potential risks and complications associated with intestinal resection surgery?
  3. How much of the intestine will be removed during the resection?
  4. What is the expected recovery time after intestinal resection surgery?
  5. Will I need to make any changes to my diet or lifestyle after the surgery?
  6. How will intestinal resection surgery affect my ability to absorb nutrients?
  7. Will I need to be on parenteral nutrition (PN) after the surgery?
  8. What are the long-term implications of intestinal resection surgery?
  9. Are there any alternative treatments or therapies that could be considered instead of surgery?
  10. How often will I need to follow up with my doctor after the surgery?

Reference

Authors: Billiauws L, Joly F. Journal: Expert Rev Gastroenterol Hepatol. 2019 Mar;13(3):241-246. doi: 10.1080/17474124.2019.1569514. Epub 2019 Feb 7. PMID: 30791759