Comprehensive modified diet simplifies nutrition management of adults with short-bowel syndrome

Short-bowel syndrome (SBS) is a complex condition resulting from massive surgical resection of the intestinal tract. Nutrient malabsorption and metabolic alterations occur as a function of the portions of bowel removed and the length of remaining bowel segment. The nutrition management of SBS is challenging; many dietary restrictions are described, but inconsistently, throughout the literature. We compiled the restrictions and developed a comprehensive diet to reestablish adult patients with SBS on oral intake after surgery. Our purpose was to simplify the task of instructing patients with SBS in a diet that restricts all categories of food substances that may be poorly absorbed: fat, lactose, insoluble fiber, oxalates, and concentrated sweets. Suggestions to increase the transit time of ingested foods are included with the diet. Patients are taught the SBS diet after surgery and have bimonthly contact with the dietitian after leaving the hospital. Categories of restricted food substances, such as lactose, may be attempted and added back to the diet if they are tolerated. Bowel adaptation enhances tolerance to various dietary components over time. If sufficient bowel adaptation occurs, some patients are eventually able to return to an unrestricted diet.