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Nutrition in short-bowel syndrome

K Ladefoged¹, I Hessov, S Jarnum

¹Medical Dept., Roskilde County Hospital, Koege, Denmark.

Scandinavian Journal of Gastroenterology. Supplement

|January 1, 1996

Summary

Short-bowel syndrome, often caused by Crohn's disease, leads to malabsorption. Dietary adjustments and home parenteral nutrition can improve quality of life for affected patients.

Area of Science:

Gastroenterology
Internal Medicine
Surgical Oncology

Background:

Short-bowel syndrome (SBS) results from extensive bowel resection, commonly due to Crohn's disease or mesenteric infarction.
Pathophysiological outcomes in SBS vary based on resection extent, remaining bowel adaptation, and secondary organ effects.

Purpose of the Study:

To outline the nutritional management and long-term outcomes for patients with short-bowel syndrome.
To detail dietary recommendations and the role of home parenteral nutrition (HPN) in managing SBS.

Main Methods:

Review of pathophysiological consequences of extensive bowel resection.
Analysis of dietary modifications (high-carbohydrate, low-fat) for patients with colon involvement.
Evaluation of fluid, electrolyte, and nutritional support needs based on remaining small bowel length.

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Assessment of outcomes for patients receiving home parenteral nutrition (HPN).

Main Results:

A high-carbohydrate, low-fat diet improves outcomes in patients with colon dysfunction, reducing diarrhea and increasing energy absorption.
Jejunostomy patients with <200 cm small bowel may require permanent parenteral saline, calcium, and magnesium.
Patients with <100 cm small bowel often need parenteral nutritional support.
50 cm of jejunum can be sufficient for oral nutrition if the colon is preserved.
The majority of HPN patients report good quality of life, with a 4% mortality rate.

Conclusions:

Nutritional management in short-bowel syndrome is tailored to the extent of resection and remaining bowel length.
Home parenteral nutrition is a viable option for many SBS patients, offering a good quality of life.
Careful monitoring of fluid, electrolytes, and nutritional status is crucial for SBS patients, especially those with limited bowel length.