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Management of the short bowel syndrome in adults

Author
John K DiBaise, MD
Section Editor
J Thomas Lamont, MD
Deputy Editor
Shilpa Grover, MD, MPH, AGAF

INTRODUCTION

Short bowel syndrome (SBS) is a disabling malabsorptive condition that is associated with frequent complications. SBS in adults usually results from surgical resection for Crohn disease, malignancy, trauma, radiation, or vascular insufficiency. SBS is the most common cause of intestinal failure. This topic reviews the management of patients with SBS. The pathogenesis of SBS and associated chronic complications of SBS are discussed in detail separately. (See "Pathophysiology of short bowel syndrome" and "Chronic complications of the short bowel syndrome in adults".)

TERMINOLOGY

Short bowel syndrome – Short bowel syndrome (SBS) is a condition that results from surgical resection or congenital disease of the small intestine which is characterized by the inability to maintain protein-energy, fluid, electrolyte, or micronutrient balances when on a conventionally accepted, normal diet [1]. It is a functional definition implying a significant amount of malabsorption of macronutrients and/or micronutrients.

The physiologic course of SBS is divided into the following phases:

Acute phase – The acute phase is characterized by high intestinal fluid losses and the metabolic derangement. It starts immediately after resection and generally lasts for three to four weeks.

Adaptation phase – The adaptation phase is characterized by structural and functional changes to the remaining small bowel and colon in order to increase nutrient absorption and slow the gastrointestinal transit. The adaptive phase usually lasts for one to two years. (See "Pathophysiology of short bowel syndrome", section on 'Intestinal adaptation'.)

                           
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Literature review current through: Nov 2017. | This topic last updated: Nov 14, 2017.
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