The main treatment for short bowel syndrome is nutritional support. Treatment may involve use of oral rehydration solutions, parenteral nutrition, enteral nutrition, and medications. Oral rehydration solutions consist of sugar and salt liquids. Parenteral nutrition delivers fluids, electrolytes, and liquid nutrients into the bloodstream intravenously—through a tube placed in a vein. Enteral nutrition delivers liquid food to the stomach or small intestine through a feeding tube.
Specific treatment depends on the severity of the disease:
• Mild short bowel syndrome treatment involves eating small, frequent meals; taking fluid and nutritional supplements; and using medications to treat diarrhea.
• Moderate short bowel syndrome treatment is similar to that for mild disease with the addition of intravenous fluid and electrolyte supplements as needed.
• Severe short bowel syndrome treatment involves use of parenteral nutrition and oral rehydration solutions. Patients may receive enteral nutrition or continue normal eating even though most of the nutrients are not absorbed. Both enteral nutrition and normal eating stimulate the remaining intestine to function better and may allow patients to discontinue parenteral nutrition. Some people with severe short bowel syndrome require parenteral nutrition indefinitely.
Long-term treatment and recovery depend in part on what sections of the small intestine were removed, how much remains, and how well the remaining small intestine adapts over time.
Intestinal transplantation may be an option for some patients for whom other treatments have failed and who have complications from long-term parenteral nutrition. These complications include blood infections, blood clots, and liver failure, which can lead to the need for liver transplantation.
What is intestinal adaptation?
After removal of a large portion of the small intestine, the remaining small intestine goes through a process of adaptation that increases its ability to absorb nutrients. The inner lining grows, increasing its absorptive surface area. Intestinal adaptation can take up to 2 years to occur. Researchers are studying intestinal adaptation and ways to help the remaining small intestine adapt more quickly and function better.