From the Guidelines
Short bowel syndrome is a condition characterized by reduced intestinal absorption, requiring macronutrient and/or water and electrolyte supplements to maintain health and/or growth, often resulting from a bowel resection that leaves a short residual length of small bowel. This condition can be acute or chronic and encompasses a wide variety of underlying medical and surgical conditions. The severity of intestinal failure (IF) can be defined as severe, moderate, or mild, depending on the need for parenteral, enteral, or oral nutritional fluid supplements, respectively [ 1 ].
Key Characteristics
- Reduced intestinal absorption
- Need for macronutrient and/or water and electrolyte supplements
- Often results from a bowel resection
- Can be acute or chronic
- Encompasses a wide variety of underlying medical and surgical conditions
Management Considerations
- Patients with short bowel syndrome may require long-term parenteral nutrition, depending on the length of residual small bowel and anatomy [ 1 ].
- Measurement of intestinal absorptive capacity can help guide dietary treatment and identify patients with suspected irreversible intestinal failure [ 1 ].
- Dietary manipulations should consider not only nutrient, electrolyte, and fluid absorption but also overall quality of life, including palatability of food, sense of satiety, and abdominal sensation [ 1 ].
- A high-carbohydrate, low long-chain triglyceride diet may be recommended for patients with a preserved colon, and medium-chain triglycerides may be beneficial [ 1 ].
Quality of Life Considerations
- Patients with short bowel syndrome may experience significant quality of life impairments, including abdominal discomfort, bloating, and fecal incontinence [ 1 ].
- Optimal nutritional care, guidance, and support are vital in the long-term management of chronic short bowel syndrome to improve quality of life [ 1 ].
From the Research
Definition and Characteristics
Related Conditions
- The studies discuss Bartter syndrome and Gitelman syndrome, which are rare inherited autosomal recessive salt-losing tubulopathies characterized by severe and chronic hypokalemia associated with metabolic alkalosis and secondary hyperaldosteronism 2.
- Bartter syndrome results from a furosemide-like defect in sodium reabsorption in the Henle's loop leading to hypercalciuria and defect in urinary concentration capacity 2.
- Gitelman syndrome is a thiazide-like salt-losing tubulopathy associated with hypomagnesemia, hypocalciuria without defect in urinary concentration capacity 2, 5.
Diagnosis and Treatment
- The diagnosis of Bartter syndrome and Gitelman syndrome is based on clinical symptoms, laboratory findings, and urinary calcium excretion 2, 5.
- Treatment of Bartter syndrome and Gitelman syndrome involves fluid and electrolyte management, lifelong oral supplementations of potassium, salt, and magnesium, and use of indomethacin or potassium-sparing diuretics in some cases 2, 5.