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Making Do With Less: Short Bowel Syndrome


Author:

Uma Sundaram, MD

University of Rochester Medical Center

Medically Reviewed On: September 05, 2002

Measuring anywhere from 15 to 20 feet, with a total surface area sometimes equivalent to that of a football field, it's hard to believe just how big the small intestine really is. We require much of our small intestine to comfortably absorb enough water, vitamins, and other food nutrients to stay healthy. But, for those who have had at least half their small intestine removed during surgery, absorbing nutrients and controlling the flow of fluid and food through the digestive tract can become very difficult. The problems associated with a shortened small intestine are known as short bowel syndrome, and the effects of this syndrome can range from mild to life threatening. Below, Dr. Uma Sundaram, Professor of Internal Medicine at University of Rochester School of Medicine, talks about the characteristics of short bowel syndrome, and how to treat it.

What is the job of the small intestine?
The small intestine is where most of the absorption of water, salt, vitamins, and all the important nutrients we eat and drink every day get absorbed and enter the body. The large intestine primarily absorbs the remaining amount of salt, electrolytes and water.

When you lose approximately 50% or more of the small intestine, either because of illnesses, surgery, or tumors, you end up with less than an ideal amount of intestine, or short bowel syndrome, which can result in malabsorption, dehydration, weight loss, and in small infants it can potentially lead to their death.

What are the main causes of short bowel syndrome?
The most common cause in the United States is Crohn's Disease, which can affect any part of the digestive tract, from the mouth to the anus. Part of the treatment of Crohn's disease can involve removing parts of the small intestine, which can then result in short bowel syndrome. The removal of certain tumors in the small intestine can result in short bowel syndrome as well.

Additionally, certain types of infections can temporarily give you short bowel syndrome by functionally removing the amount of absorptive surface the small intestine has.

Are there different degrees of short bowel syndrome?
There are different degrees or severity of short bowel syndrome, and the severity depends on how much of the small intestine has been removed. If you have more than 50% of your small intestine, you may have a mild case, and it presents itself when you overwhelm the small intestine's ability to do what it normally does. For example, if you decide to eat or drink excessive amounts, then you can overwhelm its normal ability to compensate.

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