Short Bowel Syndrome SBS

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Short Bowel Syndrome (SBS)

• By Erica Gidman
• MSU Dietetic Intern

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Short Bowel Syndrome?

• What is SBS?
• Inflammation of the GI tract
• Malabsorption of food nutrients
• Resulting from disease or surgery of SI

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Causes of SBS

• What causes SBS?
• Crohns Disease
• Necrotising Enterocolits
• Ulcerative Colitis
• Bowel Surgery
• Bowel Bypass Surgery

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Reasons for Removal

• Crohns Disease
• Necrotizing Enterocolitis
• Intestinal Atresia
• Failure of Development
• Volvulus

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Normal Absorption

• Food enters the Small Intestine
• Duodenum
• 1st part of SI
• Food mixes with digestive enzymes
• Peristalsis occurs, pushing food to lower SI
• Lower SI
• Jejunum
• Illeum

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Nutrient Deficiencies

• Vit B12-may result in neurologic deficits
• Ca and Mg-lead to encephalopathy, tetany and
  convulsions
• CHO-may escape SI and ferment by colonic bacteria
• Loss of electrolytes may cause hypokalemia

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SBS Symptoms

• Abdominal pain
• Diarrhea
• Heartburn
• Floating stool or fowl smelling stool
• Unintended weight loss
• Extreme fatigue
• Swelling
• Dehydration

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Complications

• Anemia
• Skin rashes
• Fatigue
• Dehydration
• Impaired growth
• Increased susceptibility to infections
• Osteoporosis

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Intestinal Adaptation

• SI Re-growth
• Inflamed portions are removed
• Healthy sections sewn together
• Organ dilates and grows bigger
• Micro-Villi become larger
• More food nutrient absorption
• Peristalsis slows for more absorption time

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Lifelong Treatment

• Managing Symptoms
• Diet
• Vitamin and Mineral Supplements
• Medications to slow peristalsis
• Bile salt binding medications
• Stomach Acid lowering meds
• Liquid diet
• SI Transplant
• Intravenous Feedings

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SBS Diet

• High Kcal
• Low Fat
• Low Residue
• High Nutrition

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Nutritional Support

• Total Parenteral Nutrition
• Enteral Nutrition
• Oral Nutrition

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SI Transplant

• Common treatment
• Lymphoid Tissue in SI
• Rejection may occur
• Immunosuppressive Drugs for Tx.

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Seeking Treatment

• Family Physician
• Gastroenterologist
• Websites
• betterhealth.vic.gov
• digestive.niddk.nih.gov