There is no cure for short bowel syndrome at present and treatment involves alleviating the symptoms suffered by the patient and working to balance the right level of nutrition needed by the body. Treatment may be coordinated across a team of surgeons, gastroenterologists and dieticians.
CONSERVATIVE TREATMENTS
Diet
If you are still able to tolerate food via oral intake then you will be encouraged to eat little and often to keep up energy and nutrition levels. There is no specific diet as these are usually tailored to the individual but advice will generally recommend avoiding an excess of sugars and a high carbohydrate and low fat diet.
TPN/ Enteral Feeds
In order to achieve the optimal nutritional status TPN (total parenteral nutrition) , which is an IV feed that enters directly into the veins and bypasses the stomach and intestine may be considered. The aim of TPN is to use it as a temporary method to improve overall health before moving on to enteral feeds via a tube directly into the stomach or bowel and then gradually back to an oral intake. Some people may require permanent TPN support although this comes with its own range of complications including lack of calcium, liver and/ or kidney issues, blood clots and gallbladder disease.
MEDICINAL
Antimotility medication
Drugs used to halt diarrhoea such as loperamide can be used to hopefully reduce the chronic diarrhoea that is suffered by most with short bowel syndrome. The medication also help to slow down the peristalsis (involuntary contractions that the bowel produces), which can hold in the bowel for longer and improve levels of absorption.
Somatropin
Somatropin is a growth hormone that is used to treat short bowel syndrome and mimics the hormone produced by the pituitary gland. This medication can help improve levels of absorption in the bowel.
Proton Pump Inhibitors/ Antacid Medication
Medications such as omeprazole are used to reduce excess acid in the stomach. Excess stomach acid has shown to hinder intestinal adaptation, which is the natural process that the bowel will try and undertake following a surgical resection.
SURGICAL
Surgery may be considered as a last resort if conservative and medicinal methods have failed to have any significant impact on the patient’s quality of life.
STEP Procedure
The STEP procedure stands for Serial Transverse Enteroplasty and is a procedure where surgeons make incisions to change the shape of the bowel into a zigzag, which will increase the length and travel time of food along the small bowel therefore aiming to improve symptoms and nutrition levels.
Small Bowel Transplant
A small bowel transplant may be the very last resort, especially if you are reliant on TPN and have experienced liver failure as a result. Quite often the operation will be performed as a double transplant alongside a liver or kidney transplant. There are still many complications associated with this procedure including the chance of rejection, risk of infection and the reliance on immunosuppressive medication.
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