Short bowel syndrome

Short-bowel syndrome results from surgical resection, congenital defect, or disease-associated loss of absorption and is characterized by the inability to maintain protein-energy, fluid, electrolyte, or micronutrient balances when on a conventionally accepted, normal diet.

Intestinal failure results from obstruction, dysmotility, surgical resection, congenital defect, or disease-associated loss of absorption and is characterized by the inability to maintain protein-energy, fluid, electrolyte, or micronutrient balance. The major difference between intestinal failure and short bowel is that intestinal failure is the result of a variety of conditions such as chronic intestinal obstruction, whereas short bowel implies a reduction of functional intestinal surface area for absorption.

The two major causes of surgical short bowel are inflammatory bowel disease and vascular disease. The risk factors for vascular disease leading to resection of the intestine are the same as those for other vascular diseases: increasing age, smoking, cardiac disease leading to low output or predisposing to embolization, hypercoagulable states, diabetes, and vasculitis.

Reducing acid secretion improves absorption in patients with a short bowel. Furthermore, hypersecretion can cause nausea, reflux, and hemorrhage from severe esophageal ulceration; these effects are prevented by proton pump inhibitors.