Nutritional Support In Short Bowel Syndrome

Abstract

Short bowel syndrome is defined as malabsorptive state, which follows massive small bowel resection. This syndrome occur when there is <200 cm of residual small bowel. In adults the most common causes of SBS is thrombosis or occlusion of the superior mesenteric artery or vein, which results in necrosis of the small bowel and half of the colon, crohn’s disease and to a lesser extent radiation enteritis are also common causes of SBS, in infants necrotizing enterocolitis and intestinal atresia are common causes of SBS. The compromise of the absorptive surface area after an extensive intestinal resection gradually may lead to malabsorption considering nutrients, water and electrolytes. There are two types of patients with SBS, some patients have had their ileum and part of the jejunum resected usually with a jejunocolic anastomosis.others had their colon, ileum and part of the jejunum resected and have ajejunostomy. Water and sodium deficiency most common in jejunostomy patient may result in hypotension, electrolyte disturbance and acute renal failure. Gall stones are common in SBS, regardless of type and most probably results from gallbladder stasis. B12 deficiency common in patient with terminal ileum resection, several vitamin deficiency is less common. Fat-soluble vitamins deficiency(A, D&E) is more common because of steatorrhea in SBS patient, Vitamin K deficiency uncommon in patient with intact colon.