About Short Bowel Syndrome
The causes of SBS include:
- Surgical removal of part of the small intestine: Often done to treat certain intestinal diseases or injuries
- Crohn's disease: A type of inflammatory bowel disease that can cause damage and narrowing in the small intestine
- Mesenteric ischemia: When blood flow to the intestines is reduced, leading to tissue damage.
- Radiation enteritis: Inflammation and scarring of the small intestine due to radiation therapy for cancer
Risk factors for SBS include:
- Congenital abnormalities: These are issues with the intestines, like blockages (intestinal atresias) or twisting (volvulus), that a person is born with.
- Necrotizing enterocolitis: This is a life-threatening infection of the intestines that can affect babies born too early.
It's important to note that these risk factors do not mean you will definitely develop SBS, but they might make it more likely. If you have concerns about your risk or symptoms, it's best to talk with a healthcare professional for the right diagnosis and treatment.
The most common early symptom of short bowel syndrome is diarrhea (frequent, loose, or watery stools), which can lead to dehydration (when the body loses too much water) and malnutrition (not getting enough nutrients). Other early symptoms may include:
- Weight loss: Losing weight without trying, often because the body can’t take in enough nutrients
- Weakness and fatigue: Feeling unusually tired or lacking energy, often due to lack of nutrients
- Cramping and bloating in the belly: Pain or discomfort, along with a feeling of fullness or tightness in the stomach area
- Swelling in the legs (edema): Fluid build-up that causes puffiness or swelling, which can happen if the body doesn’t get or use certain nutrients right
- Nausea and vomiting
- Foul-smelling or pale, greasy stool: Stools that smell bad, look pale, or appear oily or shiny, which can happen when the body doesn’t fully digest fats
- Heartburn and gas: A burning feeling in the chest or stomach and too much gas in the digestive system, leading to burping or passing gas
As SBS becomes more serious, it can cause additional problems because the body isn’t able to take in enough nutrients from food. Without enough of these, specific symptoms can happen. These can include:
- Dry skin and muscle loss: These can happen because of dehydration, which means the body doesn’t have enough water. In SBS, water and nutrients aren’t fully taken in, known as malabsorption. This lack of water intake can lead to dry skin, and the reduced nutrients weaken and shrink muscles over time.
- Vision problems: May result from low levels of vitamin A, which is important for eye health
- Seizures and irregular heartbeat: These can happen due to low vitamin B levels, which support nerves and muscles.
- Muscle spasms and osteoporosis (weak bones): Caused by low levels of vitamin D, which are needed for strong bones and muscles
- Trouble with muscle control: This can happen if the body is low on vitamin E, which helps protect nerves.
- Skin color changes and bruising: Linked to a lack of vitamin K, which helps blood clot properly
- Pale skin, mental fog, and shortness of breath: Signs of low iron levels, which is needed to carry oxygen in the blood
- Hair loss and skin rashes: These may happen when the body lacks zinc, which is important for healthy skin and hair.
It's important to note that these symptoms can be different based on how much of the intestine is still working well. If you have any of these symptoms or think you may have SBS, it's best to talk with your healthcare professional for the right diagnosis and treatment.
To diagnose short bowel syndrome (SBS) and determine its severity, doctors commonly perform the following exams, tests, and procedures:
- Medical history: Your doctor will ask about your symptoms and medical history, including any past surgeries where a part of the small intestine was removed.
- Physical exam: During a physical exam, your doctor will check your body for signs of poor nutrition, dehydration, and low levels of certain vitamins and minerals. They may also look for other health problems linked with SBS.
- Blood tests: These tests can check the levels of vitamins and minerals. They can also check for anemia (not enough healthy red blood cells to carry oxygen in the body).
- Stool sample (fecal fat test): A stool sample may be tested to see how well your body is taking in fat. This checks if any fat is being lost instead of being taken in. b
- Imaging tests: The following imaging tests may be used to look for any blockages or unusual areas in the intestines.
- CT (computed tomography) scans,
- Upper GI series (barium study): This test uses a chalky liquid called barium, which you drink before the test. The barium helps create clear x-ray images of the upper digestive tract so doctors can look for blockages or other issues.
- Abdominal ultrasounds
Additional exams, tests, and procedures to determine the stage or severity of SBS may include:
- Nutritional assessments to check how well your body is taking in nutrients and to check your overall nutritional levels
- Intestinal length measurement: Specialized imaging to measure the length of the intestine to understand how much is functioning
- Liver function tests: Check on liver health, as problems like liver disease (cirrhosis) can be linked to SBS.
Remember to talk your healthcare professional about which specific exams, tests, or procedures are right for your situation.
The goals of treatment for SBS are to make sure the body gets enough nutrition, prevent complications, and reduce the need for parenteral nutrition (a method of delivering nutrients directly into the bloodstream for people who can’t get enough nutrition through eating). Here are the different types of treatments and how they work to achieve these goals:
- Nutrition support: The main treatment for SBS is nutrition support. This may include enteral nutrition (feeding through a tube into the stomach or small intestine) or oral supplements. The goal is to provide enough nutrients to meet the body's needs.
- Fluids and electrolytes: Replacing fluids and electrolytes (minerals like sodium and potassium) helps keep the body from becoming dehydrated. Treatment focuses on replacing these lost fluids and electrolytes to keep the body working well.
- Medicines: Some medications help manage symptoms and improve nutrient absorption. Examples include:
- Anti-diarrheal medications to help slow down bowel movements, giving the intestines more time to absorb nutrients and fluids
- Acid-reducing drugs to lower the stomach acid and help with absorption
- Medications to help move food through the intestines (promote intestinal motility)
- Surgery: In some cases, surgery may be needed to improve how well nutrients are taken in.
- Bowel lengthening involves making the small intestine longer, which allows for more space for nutrient absorption.
- Increasing the surface area of the intestine means creating more room in the intestine to absorb nutrients. Procedures like stricturoplasty (widening narrow sections of the intestine) can help achieve this.
- Health behavior changes: Making certain lifestyle changes can also help manage SBS. These may include eating smaller meals more often, avoiding certain foods that make symptoms worse, staying hydrated, and keeping a healthy weight.
It's important to note that treatment plans will be different based on each person’s needs and how serious their SBS is. Always talk with a healthcare professional for personalized advice.
Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Other side effects can occur. Check with your health care professional or read the information provided with your medication for additional side effect information.