What is Short Bowel Syndrome?
Short Bowel Syndrome is a condition where in there is a small bowel surgical resectioning done extensively which eventually lead to fluid electrolyte loss, malnutrition and malabsorption problems. It is otherwise termed as short gut syndrome or SBS. It may be due to a surgical resection or perhaps a complete dysfunctional large portion of the person’s bowel. It is a complication that results to the occurrence when the person’s bowel is removed.
Short Bowel Syndrome Symptoms
Persons who have Short Bowel Syndrome have the following characteristics, symptoms, and signs manifested:
- Bloating sensation
- Weight loss
- Bacterial infections
- Sensitivity on food
- Abdominal pain
- Fluid depletion or loss
- Easily bruised
- Pale stools
- Foul smelling stools
- Edema in the legs
- Poor blood clotting
- Bone pain
- Hyperkeratosis or skin scaling
- Muscle spasm
Aside from the ones mentioned, the persons who have short bowel syndrome are known to lack or deficient in folic acid, zinc, vitamins ADEK and B12, iron, calcium, and magnesium.
Shortening of the Bowel Causes problems in Absorption
Short Bowel Syndrome Causes
The etiology behind the short bowel syndrome may be acquired or congenital reasons. During the prenatal period, when a person has this syndrome it may be due to the isolation of the intestinal atresia,meconium plug or ileus, multiple atresias found in the person’s small intestines, Hirschsprung’s disease which is extensive or gastroschisis.
However, when a person develops such syndrome upon the postnatal and neonatal period, it may be due to the fact that it is a result of the enterocolitis which has been necrotized. The necrotized enterocolitis are commonly reported on infants who are premature and it leads to injury, particularly ischemic injury, of the person’s small intestines which results to the need for bowel resectioning.
Persons who are older acquire this syndrome because they have developed volvulus due to intestinal ischemia or they have Crohn’s disease which is extensive in nature, as well as radiation enteritis, tumors or perhaps trauma in the abdominal region which leads to having such disease condition.
In sum, the common risk factors that are associated with a possibility of acquiring the Short Bowel syndrome are as follows:
- Premature babies
- Problems in the vascular system
- Crohn’s disease
Short Bowel Syndrome Diagnosis
Physicians are the ones who diagnose if a person really has short bowel syndrome. For confirmatory diagnosis they let the person run down some tests or examinations such as:
- Medical history examination (protocol)
- Physical examination (protocol)
- Blood chemistry examination to detect anemia and check for the albumin level
- Fecal fat examination for determination of Steatorrhea and to know if the person is rightly absorbing the dietary fat amount that is needed for the right healthy nutrition
- Complete blood count examination
- Vitamin level in the person’s blood kind of examination
- CT enterography examination which is a noninvasive imaging test to detect abnormalities in the person’s intestines
- Small intestine x-ray examination to detect any complications such as gallstones and kidney stones
- CT scan examination to detect any abnormalities
- Colonoscopy examination which is done to inspect the person’s colon and small intestines
- Endoscopy examination which is done to inspect the person’s, anatomically arranged, esophagus, stomach and duodenum
- Bone densitometry can be also done which determines the bone mineral density of the person and because osteoporosis is a complication associated with this syndrome
Short Bowel Syndrome Treatment
In treating the short bowel syndrome the following treatment management is expected:
Diet and Nutrition Management
The particular diet and nutrition treatment management differs from one person to another. The primary basis of this are the patient’s body mass index, food preferences, age, lifestyle, gender, eating habits and the total health condition of the patient himself or herself.
The dietary guidelines in persons with this syndrome are as follows:
- Including beverage in the diet to prevent dehydration
- Limiting fluid intake during meals to avoid dumping syndrome or pushing food through the person’s bowel in a fast rate which may lead to inadequate absorption and digestion
- Eating small yet frequent meals
Aside from that, the meals should be rich in refined carbohydrates, protein, vitamins, and nutrients, moderate in fat, and low in fiber, lactose, and concentrated sweets. Other physician would require patients with this syndrome, a gastrostomy tube and under TPN or total parenteral nutrition in the beginning or throughout the person’s life depending on the assessment made by the physician.
Physicians would usually prescribe medications to patients with this kind of syndromes. Such medications like:
- Antibiotics which prevents any resistance from bacteria
- H2 blockers for acid and gastric hypersecretion
- Proton pump Inhibitors also used for gastric acid hypersecretion
- Choleretic Agents which prevents TPN or total parenteral nutrition induced liver disease and improves the flow of billary
- Bile salt binders which is used to decrease the Choleretic diarrhea symptom
- Antisecretin agents which decreases intestinal secretions
- Hypomotility agents which aids in increasing the transition time of the intestines
This is the last option. What is done here is that there is a transplantation of the small bowel which is done to patients who can no longer manage well their nutritional status with the given treatment management mentioned earlier.
Surgery For Small Bowel Syndrome Employs transplantation of the Portion of the Small Intestines
Prognosis and Life Expectancy
There is an unknown cure for short bowel syndrome. The life expectancy of most infants having this kind of syndrome will lie between 4 to 5 years of survival rate. However, there is a possibility with improvement as a result of surgical procedure or the treatment done. When this happens, there will be an improvement, made gradually, in the absorption of the nutrients.
The possible complications which are associated with Short Bowel Syndrome are as follows:
- Renal stone formation or kidney stones
- D-lactate acidosis
- Peptic ulcer
- Cholelithiasis or gall stones
- TPN liver disease
- Anastomotic Ulceration
- Weight loss
- Bowel obstruction
- Necrosis of the bowel
- Osteomalacia or weak bones
- Overgrowth of bacteria found in the small intestines
- Transplant rejection (whether acute or chronic rejection)
- Nervous system degeneration due to the deficiency in vitamin B12
- Portal, hepatic or mesenteric thrombosis of the vein