Short Bowel Syndrome

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.