How Short Bowel Syndrome Affects Nutrition Absorption
In the digestion process, most of the nutrients you consume are absorbed in the small intestine, but just because you consume the nutrients, does not mean your body uses them. When damage occurs to the small intestine, it can lead to malnutrition and other symptoms in a rare condition known as short bowel syndrome.
What is Short Bowel Syndrome?
About three people out of every million are affected by short bowel syndrome. This complex disease occurs when parts of the small intestine lose their function or part of the intestine has been removed. Cases of short bowel syndrome range from mild to severe depending on how well the rest of the small intestine works. When the small intestine does not operate per normal, there is poor absorption of nutrients the body needs, leading to several symptoms.
Short bowel syndrome can disable proper absorption of water, vitamins, minerals, proteins, fats, calories, and other nutrients that come from food. The specific nutrients the body has difficulty absorbing depends on which part of the small intestine has been removed, damaged, or has poor motility.
Causes of Short Bowel Syndrome
Short bowel syndrome is either acquired during a person’s life or it is a congenital condition that stems from birth. The main cause of short bowel syndrome is when a patient has surgery to remove a portion of their small intestine. These surgeries can be from the treatment of cancer, Crohn’s disease, gastroschisis, hernia, intestinal injury, and more. When short bowel syndrome is congenital, babies are born with portions of their small intestine missing or damaged, but research has not yet answered the question about why this happens.
What Are the Symptoms?
Some of the symptoms of short bowel syndrome include:
- Diarrhea (the main symptom)
- Greasy, foul-smelling stools
- Fatigue or weakness
- Weight loss
People with short bowel syndrome may also develop food allergies and sensitivities, such as lactose intolerance. Additional symptoms may appear as a result of malabsorption, such as dehydration or swelling (edema) in the lower extremities. Be sure to consult a doctor for any symptoms that concern you.
After a doctor’s assessment, they will outline which treatments are best suited to your particular condition. Treatment depends on which parts of the small intestine are affected by short bowel syndrome, the state of the colon, and your preferences.
Treatment methods may include nutritional support, medication, surgery, and clinical trials.
This treatment requires patients to follow a special diet and take nutritional supplements as recommended by a healthcare professional. Different components of this treatment include:
- Diet changes. A diet may outline smaller meals more frequently, avoiding diarrhea-causing foods (like those high in sugar, protein, and fiber), and giving up high-fat foods.
- Oral rehydration. This encourages adults to drink more caffeine-free fluids and children to drink age-appropriate rehydration solutions, like Pedialyte.
- Parenteral nutrition. This uses an intravenous tube that delivers fluids, electrolytes, and liquid vitamins and minerals directly to the bloodstream.
- Enteral nutrition. Essentially, a feeding tube delivers liquid food to the stomach or small intestine.
- Vitamin and mineral supplements. These may be suggested by a doctor during or after parenteral or enteral nutrition to ensure patients get all the nutrients they need.
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Drug treatments can help manage symptoms of short bowel syndrome. Medications may be advised by your doctor as a way to control stomach acid, reduce diarrhea, or help improve intestinal absorption. Doctors may prescribe:
- Antibiotics to stop or prevent the growth of bacteria
- H2 blockers when there is too much gastric acid secretion
- Proton pump inhibitors for too much gastric acid secretion
- Choleretic agents to improve bile flow
- Bile-sale binders to minimize the occurrence of diarrhea
If other types of treatment do not work, a doctor may recommend surgery as a solution to improve the small intestine’s ability to absorb nutrients for the body. About half of patients affected by short bowel syndrome require surgery. The type of surgery a person requires depends on the specific issue within the small intestine. Types of surgery for short bowel syndrome may include procedures to:
- Lengthen the intestine
- Slow the passage of nutrients as food goes through digestion in the small intestine
- Prevent blockage
- Narrow dilated segments of the small intestine
- Remove damaged or injured small intestine and replace it with healthy intestine from a donor (intestinal transplant)
Clinical trials are part of clinical research and there may be a short bowel syndrome clinical trial underway when you go through treatment. Clinical trials help with advances in medicine by exploring new ways to prevent, detect, or treat diseases.
Research into short bowel syndrome is ongoing and as of yet scientists have not discovered a way to prevent this disease if it is congenital. Health conditions that require a part of the small intestine to be removed, such as certain types of cancer, increases the risk of short bowel syndrome. Monitoring your health and seeing a doctor for any worrisome symptoms may address other health issues before they require surgery.
In general, diet and nutrition changes are recommended to reduce or prevent symptoms of short bowel syndrome. Some adjustments to how you eat may help. Factoring in which parts of the small intestine have been removed or damaged, here are some things to try:
- Small, frequent meals
- Drinking fluids between meals instead of during meals
- Switching to low-fat foods
- Eating high protein and less sugar
- Eating foods that may control diarrhea, such as bananas, rice, oatmeal, and more
- Taking multivitamins recommended by your doctor (they may advise of magnesium, calcium, iron, or vitamin B12)
Talk to Your Doctor
Digestion is not only about what you eat, but what your body does with those nutrients. Seeing a doctor and starting treatment helps you get the nutrients you need to optimize your health and power your day.