A patient with short bowel syndrome, also called Short Bowel Syndrome (SBS), has a shortage of properly functioning intestinal tissue. This mainly concerns the small intestine. Normally the small intestine is about five meters long. It plays an important role in digestion. If there is less than two meters of small intestine present, all kinds of complaints arise. What exactly does short bowel syndrome mean and what can be done about it?
What Short Bowel Syndrome entails
Short Bowel Syndrome is characterized by a deficiency of properly functioning intestinal tissue. In a healthy adult, the small intestine is about 5 meters long and the large intestine is over one meter. In short bowel syndrome, a large part of the bowel is absent or does not function. This is usually the result of surgery to remove part of the intestine. The small intestine has a large overcapacity. Even if only half are present or functioning, this usually causes hardly any complaints. If less than 2 meters of small intestine is still functioning, it is called short bowel syndrome.
The function of the small intestine
After food enters the stomach, it passes through the duodenum into the small intestine. The small intestine is where the most important part of digesting food takes place. Nutrients are delivered to the body through the wall of the small intestine. The body uses this as a building material and as an energy source. What remains in the form of a watery slurry of indigestible nutrients ends up in the large intestine.
The function of the large intestine
The large intestine is over a meter long and continues into the rectum, the last part of the digestive tract. In the large intestine, moisture, salts and minerals are mainly extracted from the food, causing the watery mass to thicken. The large intestine also contains many bacteria that contribute to digestion. This creates stool that is stored in the rectum until you feel the urge to go to the toilet for a big errand.
Complaints
If less than 2 meters of the intestine is still functioning, all kinds of complaints can arise. The shorter the remaining part of the intestine, the worse the complaints usually are. Particularly because there is less absorption of important nutrients such as proteins, vitamins and minerals. This is also called malabsorption. This can cause serious shortages. This can cause the following complaints:
- Weight loss
- Fatigue
- Fatty diarrhea
- Stomach ache
- Bone decalcification
- Night blindness
- Anemia
There are complications that can occur with Short Bowel Syndrome such as kidney stones and gallstones.
Treatment of short bowel syndrome
Treatment is determined on the basis of the complaints, the nutrient deficiency and the length of the remaining part of both the small and large intestines. Mild forms of Short Bowel Syndrome can be treated with an adjusted diet that will include increased food intake. Sometimes this is supplemented with tube feeding and nutritional supplements. In children, surgery is sometimes performed to increase the functioning intestinal surface area. A doctor can sometimes prescribe medications that bind bile salts in the feces or antacids. In very serious cases, a small intestine transplant will have to be performed. This is a very drastic and difficult operation. The treatment for short bowel syndrome can vary greatly from person to person.
Adaptability of the intestine
In addition to the large reserve capacity of the small intestine, both the small and large intestines have great adaptability. This allows the remaining parts of the intestine to take over the functions of the removed part of the dam. This adaptability is also called adaptation. This does take some time, because complaints often only decrease in the months and sometimes years after an operation. In children, the adaptability is usually greater than in adult patients.