Short bowel syndrome (SBS) occurs when a large portion of the intestine does not work normally. This can occur if a large section of the intestine has been surgically removed or if a baby is born with an abnormally short intestine.

Complications of SBS

• Child does not gain weight (sometimes labeled “failure to thrive”)
• Dehydration
• Vitamin deficiencies as a result of poor absorption in the intestine
• Ulcers from excess stomach acid
• Bacterial overgrowth in areas of dilated intestine
• Kidney stones or gallstones due to poor absorption of calcium or bile
• Liver disease

Causes of SBS

When present at birth, short bowel syndrome can be caused by:

• Narrowing or obstruction of the intestines
• Abnormally short small intestine;

SBS can occur as a result of surgery:

• NEC (necrotizing enterocolitis) in babies
• Twisting of the intestine (volvulus)
• Intestinal resection for Crohn’s disease
• Removing part of the intestine for other reasons (tumors, abnormal blood supply, strictures, etc.)

Other issues:

• Intestinal pseudo-obstruction or abnormal motility of the bowel
• Damage to the intestines from radiation therapy

Symptoms

• Poor weight gain or weight loss
• Bloating
• Poor appetite
• Increased gas
• Foul smelling stools
• Fatigue
• Pale or pasty-looking skin
• Vomiting

Treatment

The right diet is key in helping the body absorb all the nutrients it needs to grow. For infants, the diet can consist of breast milk or formulas that are pre-digested or hypoallergenic. At the initial stage of treatment, IV nutrition is usually needed for growth and good hydration.

Treatment of vitamin deficiency and anemia is also very important.

It is hoped that the bowel will grow in size and adapt to eventually be able to perform all the required functions without the need for IV nutrition.

Depending on the cause and severity for conditions such as intestinal malrotation and volvulus, intestinal atresia, gastroschisis, and long-segment Hirschsprung Disease surgical care may be needed. Intestinal transplantation can be considered for severe forms of short bowel syndrome. In these cases, patients are seen by the Intestinal Rehabilitation Center.