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Short Bowel Support
 
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A Patient’s Guide to Managing a Short Bowel

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Types of Short Bowel Syndrome treatment

Several methods may be used to help you manage your Short Bowel Syndrome. Your treating doctor will help you find the right treatment plan based on your individual needs.

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Nutrition

The primary treatment for (SBS) requires ensuring that the patient absorbs the proper amount of nutrition and fluid. People with SBS may receive their nutrition through oral, enteral and/or parenteral delivery. Many people will use a combination of these methods over time.

Enteral nutrition

This form of nutrition is delivered through a feeding tube that is inserted directly into the stomach or small bowel. Staying on enteral nutrition or continuing to eat orally stimulates the digestive process, which can help maintain or improve the absorptive power of the remaining bowel. A partially functioning GI tract is necessary for enteral nutrition to be effective.

Parenteral nutrition

Parenteral nutrition (PN) is liquid food usually delivered through a catheter directly into the bloodstream, instead of through the stomach and small intestine. Depending on your diagnosis, you may only require intravenous (IV) fluids and electrolytes administered through a catheter. The catheter is a thin tube that is surgically inserted into the body, usually in a large vein in the chest or arm, for the purpose of delivering PN and fluids.

PN contains nutrients such as proteins, carbohydrates, fats, vitamins or minerals. PN is often customized to deliver specific nutritional needs. Most people are familiar with PN delivered in the hospital setting, but many people with SBS receive their PN at home.

Because PN can deliver many of the nutrients needed to sustain life in people with SBS, it has been the standard treatment for decades.

Adjustments to diet

There is no single, established diet for SBS. Each diet is customized, depending on the portion and length of the remaining bowel, and how it is functioning. Most doctors will encourage people with Short Bowel Syndrome to continue to eat if possible, since eating can stimulate absorption. People with SBS who are maintained on an oral diet may need to consume much larger amounts of food than a person with a normal-sized bowel to compensate for their inability to absorb sufficient amounts of nutrients and fluids.

Talk to your doctor or a registered dietician about how to improve nutrition and overall health with your diet. Generally, for people with Short Bowel Syndrome, meals should be:

  • High in protein
  • High in refined or low-fiber complex carbohydrates
  • Moderate in fat (if a large section of the ileum has been removed, fats may be better tolerated earlier in the day)
  • Low in concentrated sweets

    Additional tips:

    • Include beverages in diet
    • Follow a low-lactose diet if lactose intolerant
    • Avoid alcohol, coffee, tea and cola drinks

Surgical procedures

A number of surgical interventions have been designed to improve intestinal absorption and bowel function if you are a patient with Short Bowel Syndrome (SBS). Typical strategies include either lengthening the intestine through lengthening procedures or transplantation. The main goals of many of these surgeries are to promote absorption and reduce dependence on PN.

  • Serial transverse enteroplasty (STEP) procedure. This creates a series of “v” shapes from the existing intestine, forming an accordion-like effect that increases bowel length and gives nutrients more time to be absorbed. This procedure does not require the removal of any additional intestine.
  • The Bianchi procedure. This divides part of the bowel lengthwise into two narrower tubes which are then separated and joined end to end. The result is a longer but narrower bowel.
  • Small bowel transplantation. This operation replaces a diseased small intestine with a healthy organ from another person. It is sometimes considered when complications occur from extended use of parenteral nutrition. These complications include continual hospitalizations due to infections and other problems at the catheter site, as well as serious diseases of the liver, gallbladder or bone.


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