short bowel syndrome

Short bowel syndrome

A condition in which the bowel is not as long as normal, either because of surgery or because of a congenital defect. Because the bowel has less surface area to absorb nutrients, it can result in malabsorption syndrome.

Mentioned in: Malabsorption Syndrome

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short bowel syndrome

Small intestinal insufficiency Surgery A complication of major small intestine resections–eg, for ischemia or inflammation, resulting in complex nutritional imbalances and/or malnutrition; massive small intestinal resection may be required in 1. Multiple congenital atresias or stenoses of the neonatal intestine; if loss is significant, diarrhea and malabsorption appear shortly after birth; barium studies reveal a malrotated colon and markedly shortened small bowel; if infant survives first few months, intestinal function improves; 2. Massive resection of gangrenous small intestine due to mesenteric arterial occlusion, traumatic interruption, volvulus, or Crohn's disease; in children, necrotizing enterocolitis is main cause of SBS; excess small intestinal resection results in inadequate absorption of nutrients, minerals and vitamins, causing hypovitaminosis, malnutrition, hypochromic and megaloblastic anemia, diarrhea, electrolyte imbalances, ↑ oxalates–derived from bile salt detergents that pass into the circulation, which may crystallize in renal tubules, causing renal failure, lactic acidosis, osteopenia, steatorrhea; up to 70% of the absorptive surface may be lost and tolerated; if the Pt survives surgery, residual tissue undergoes adaptive hyperplasia of absorptive villi, ↑ absorptive cells and ↑ in small intestinal caliber; after stabilization and temporary parenteral nutritional support, oral feeding must be initiated ASAP to stimulate adaption Treatment High 'quality'–ie, essential amino acids, low protein diet, middle chain TGs, vitamins, minerals. See 'Second look' operation.