Short bowel syndrome (SBS) occurs when the body can’t absorb enough nutrients from fluids and foods due to a removed, damaged, or diseased section of the small intestine. It affects an estimated 10,000 to 20,000 adults and children in the United States. 

“SBS in infants is usually caused by congenital abnormalities or surgical removal of parts of the intestine related to damage or disease,” explains Brandi Gerhardt, MSN, RN, Liver/Intestine Transplant Coordinator specializing in intestinal rehabilitation. “Over time, an infant’s shortened bowel will lengthen as they grow into childhood, adolescence and adulthood.” 

In adults, SBS is typically caused by massive resections related to surgical complications, trauma, or removal of diseased intestine. Adults do not have the ability to regenerate intestine as children do, so their intestine will remain shortened.

How does short bowel syndrome affect the body?

Short bowel syndrome can also affect other organs in the following ways: 

• Kidneys – SBS can cause large fluid shifts due to vomiting and diarrhea, making it harder for the kidneys to produce adequate urine.

• Colon – When parts of the small intestine are missing, nutrients and bile salts move too quickly to the colon, forcing it to work harder than normal and act as a reservoir for the fluids.

• Bones – When the body is struggling to absorb calcium from the gastrointestinal tract, it will seek calcium from bones. This leads to decreased mineral density of the bones, resulting in osteopenia or osteoporosis.

• Skin – SBS can make it difficult to stay hydrated, leading to dry or chapped skin. Vitamin and mineral deficiencies can also lead to skin issues or hair loss.

• Brain – Lack of essential fatty acids, acidosis, or malnutrition can harm brain function over time.

What is the best diet for short bowel syndrome?

The SBS diet primarily contains foods which are calorie dense and offer a good amount of protein along with calories. Patients should avoid drinking plain water and choose low-sugar options that offer electrolytes, especially sodium.

“In general, patients with short bowel syndrome should eat small, frequent meals and avoid eating large quantities of food in one sitting,” says Gerhardt. “This helps the intestine with absorption and doesn’t over stress the shortened gut.”

Patients with SBS are also at risk of certain vitamin and mineral deficiencies as they lack the portion of the intestine which absorbs them. Common deficiencies include Vitamins A, B12, C, D and E, Carnitine, Copper, Iron, Selenium and Zinc. These deficiencies can be addressed with changes in diet and supplementation. 

How is short bowel syndrome treated? 

SBS is a chronic medical condition but isn’t life-threatening. Most patients will have the same life expectancy as those without SBS. The condition should be managed by a medical and surgical team that specializes in intestinal rehabilitation. Patients should continue care from a team of specialists, including a surgeon, gastroenterologist, registered nurse, dietician, social worker and psychologist. Nebraska Medicine’s intestinal rehabilitation team is known nationally for their positive patient outcomes. They have more than 30 years of experience treating patients with short bowel syndrome and intestinal failure. 

“The best way to live a long, normal life is by following with a program that specializes in SBS management, having consistent medical care, and sticking to your diet plan and medication regimen,” says Gerhardt. “Patients who are dependent upon total parenteral nutrition, an intravenous feeding that bypasses the gastrointestinal tract, can often have it administered overnight so they can be free of infusions during the work or school day.” 

Can short bowel syndrome be cured?

Currently, the only cure for short bowel syndrome is with intestinal or multi-visceral transplantation.  However, thanks to medical and surgical advancements, central line care and total parenteral nutrition (TPN) management, patients can live full, healthy lives without needing a transplant.