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Short Bowel Syndrome

  • Barbora Knappe-Drzikova
  • Mirjam Karber
  • Sophie Pevny
  • Ulrich-Frank PapeEmail author
Chapter

Abstract

Short bowel syndrome (SBS) is a rare clinical condition which often results in chronic intestinal failure (CIF) due to surgical resection of parts of the gastrointestinal tract. The surgery may be necessitated by severe complicated inflammatory bowel disease, mesenteric infarction, mesenteric thrombosis, or abdominal trauma. In general, SBS patients present with heterogeneous postsurgical small and/or large bowel anatomy resulting in decreased absorptive surface area and compromised absorptive function. Oral autonomy may be ultimately acquired in some but not in all patients. In particular, irreversible CIF is associated with deficient calorie, nutrient, and fluid absorption and often requires permanent or intermittent parenteral nutrition for maintaining homeostasis of metabolism and hydration status. Handling parenteral nutrition requires individual metabolic consideration and eventually adjustment, vivid monitoring of fluid and electrolyte as well nutritional status and accurate care and hygiene of the central venous catheter access. Long-term complications of CIF and SBS may comprise macro- or micronutrient and/or fluid deficiency, renal impairment, endocarditis, and/or intestinal failure-associated liver disease (IFALD). Intestinal transplantation and a glucagon-like peptide-2 analogue (teduglutide) have emerged as additional successful therapeutic options for patients with complicated CIF.

Keywords

Short bowel syndrome Intestinal failure Intestinal adaption Oral intake Clinical management Parenteral nutrition 

Abbreviations

BW

Bodyweight

CD

Crohn’s disease

CIF

Chronic intestinal failure

CT

Computed tomography

EN

Enteral nutrition

ESPEN

European Society for Clinical Nutrition and Metabolism

GLP-2

Glucagon-like peptide-2

HPN

Home parenteral nutrition

i.m.

Intramuscularly

i.v.

Intravenously

IF

Intestinal failure

IVF

Intravenous fluid support

MRI

Magnetic resonance imaging

PN

Parenteral nutrition

PPN

Partial parenteral nutrition

PS

Parenteral support

s.c.

Subcutaneously

SBS

Short bowel syndrome

TPN

Total parenteral nutrition

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Barbora Knappe-Drzikova
    • 1
  • Mirjam Karber
    • 1
    • 2
  • Sophie Pevny
    • 1
  • Ulrich-Frank Pape
    • 1
    Email author
  1. 1.Medical Department, Division of Hepatology and Gastroenterology (including Metabolic Diseases)Charité – Universitätsmedizin BerlinBerlinGermany
  2. 2.Medical Department, Division of Gastroenterology, Oncology, Hematology, Rheumatology and Diabetes, Campus Ruppiner KlinikenBrandenburg Medical SchoolNeuruppinGermany

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