Short bowel syndrome is a group of problems related to poor absorption of nutrients that typically occurs in people who have had half or more of their small intestine removed. The small intestine is where most digestion of food and absorption of nutrients occur. People with short bowel syndrome cannot absorb enough water, vitamins, and other nutrients from food to survive.

Symptoms

Diarrhea is the main symptom of short bowel syndrome. Diarrhea can lead to dehydration, malnutrition, and weight loss. Without proper treatment, these problems can be severe and can cause death. Other symptoms may include cramping, bloating, heartburn, weakness and fatigue

Specific nutrient deficiencies may occur depending on what sections of the small intestine were removed or are not functioning properly. Sites of nutrient absorption in the small intestine are

  • the duodenum, the first section of the small intestine, where iron is absorbed
  • the jejunum, the middle section of the small intestine, where carbohydrates, proteins, fat, and vitamins are absorbed
  • the ileum, the last section of the small intestine, where bile acids and vitamin B12 are absorbed.

People with short bowel syndrome are also at risk for developing food sensitivities.

Causes

The main cause of short bowel syndrome is surgical removal of half or more of the small intestine to treat intestinal diseases, injuries, or defects present at birth.

Short bowel syndrome can also be caused by disease or injury that prevents the small intestine from functioning as it should despite a normal length.

Risk Factors

Short bowel syndrome (SBS) can occur in a person of any age. Risk factors for SBS include defects existing at birth and diseases of the small intestine that require extensive or recurrent surgery such as Crohn’s disease or gastrointestinal cancers. In addition SBS can be caused by loss of function due to injury or disease in a normal length small intestine. Other explanations include emergency situations related to injury or trauma, perforated bowel, or blocked or restricted blood flow to the bowel.

 Complications

  • Bacterial overgrowth in the small intestine
  • Nervous system problems caused by a lack of vitamin B12
  • Too much acid in the blood (metabolic acidosis due to diarrhea)
  • Gallstones
  • Kidney stones
  • Malnutrition
  • Weakened bones (osteomalacia)
  • Weight loss

Prevention

There are no current guidelines to prevent short bowel syndrome.