Short Bowel Syndrome

Abstract

Short bowel syndrome occurs after extensive loss of small bowel leading to a status of intestinal failure characterized by significant problems in digesting and absorbing enteral nutrition. A very complex adaptation process of the intestine allows that 90% of the patients can be weaned after a long-term period from parenteral nutrition. A small number of patients will finally need surgical interventions either to reduce a very fast passage time or to lengthen the dilated intestinal remnants. Some patients will need intestinal or combined intestinal/ liver transplantation either after nearly total loss of small bowel or after severe complication such as intestinal failure-associated liver insufficiency. The therapeutic decisions have to be tailored to each individual patient depending which parts of the intestine are lost or which dysfunctions of the intestinal remnants need a special treatment. Survival rates reach today nearly 90% including some children with long-term home parenteral support, additionally to the enteral nutrition.