Our Summary

This research paper is about a condition known as Short Bowel Syndrome (SBS), which happens after a large part of the small intestine has been removed. This leaves the patient with a much shorter bowel than normal, sometimes with parts of the colon (the lower part of the digestive system) also removed. Because the small intestine is where most of our food is absorbed into the body, SBS patients struggle to get enough water and nutrients. They often need to be given nutrition directly into their bloodstream.

The researchers aim to better understand what happens in the body after SBS and how it tries to adapt to the shorter bowel. They believe that if we understand these changes better, we could improve how we manage nutrition in these patients, reduce the need for direct bloodstream feeding, and prevent episodes of a condition called D-encephalopathy (a serious complication of liver diseases).

This paper is specifically about these changes in adults with SBS and does not look at cases in children.

FAQs

  1. What is Short Bowel Syndrome (SBS) and what causes it?
  2. How is SBS managed in patients with severe water and nutrient malabsorption?
  3. What is the significance of understanding the pathophysiology of SBS and postoperative adaptations?

Doctor’s Tip

One helpful tip a doctor might tell a patient about intestinal resection is to follow a well-balanced diet and stay hydrated to support optimal digestion and absorption of nutrients. It is important to work closely with a healthcare team, including a dietitian, to ensure that nutritional needs are being met and to monitor for any potential complications. Regular follow-up appointments and monitoring of blood work can help track progress and adjust treatment as needed. It is also important to communicate any symptoms or concerns with your healthcare provider to ensure proper management of your condition.

Suitable For

Patients who are typically recommended intestinal resection are those with short bowel syndrome (SBS), which occurs after extensive resection of the small bowel resulting in a bowel length of less than 150/200 cm. These patients experience severe water and nutrient malabsorption and may require parenteral nutrition (PN) to supplement their oral intake. Patients with SBS may have had their colon partially or completely removed. It is important for healthcare providers to have a complete understanding of the pathophysiology of SBS and postoperative adaptations in order to effectively manage patient nutrition and reduce the need for PN.

Timeline

Before intestinal resection:

  • Patients may present with symptoms such as severe diarrhea, weight loss, malnutrition, and dehydration
  • Diagnostic tests such as imaging studies, blood tests, and endoscopy may be performed to determine the extent of the intestinal disease
  • Surgery may be recommended if other treatments are not effective in managing the condition

After intestinal resection:

  • Patients undergo surgery to remove the diseased portion of the intestine
  • Postoperative care includes monitoring for complications such as infection, bowel obstruction, and leakage from the surgical site
  • Patients may require temporary or permanent ostomy placement to divert stool away from the surgical site
  • Rehabilitation and nutrition counseling may be necessary to help patients adjust to life with a shortened intestine
  • Long-term management may involve dietary modifications, supplements, and medications to manage symptoms and prevent complications.

What to Ask Your Doctor

  1. What is the reason for needing an intestinal resection and what specific part of the intestine will be removed?
  2. What are the potential risks and complications associated with the intestinal resection surgery?
  3. How will the surgery affect my digestive function and nutrient absorption?
  4. What dietary changes or restrictions will I need to follow after the surgery?
  5. Will I need to take any medications or supplements to support my digestion and nutrient absorption?
  6. How long is the recovery process expected to be and what can I expect in terms of post-operative care and follow-up appointments?
  7. Are there any long-term effects or complications that I should be aware of after the surgery?
  8. Will I need to make any lifestyle changes or modifications to manage my condition after the surgery?
  9. Are there any alternative treatments or therapies that may be beneficial in conjunction with the intestinal resection surgery?
  10. What are the signs and symptoms that I should watch for that may indicate a complication or problem following the surgery?

Reference

Authors: Billiauws L, Thomas M, Le Beyec-Le Bihan J, Joly F. Journal: Nutr Hosp. 2018 May 17;35(3):731-737. doi: 10.20960/nh.1952. PMID: 29974785