Short bowel syndrome

Short bowel syndrome has significant morbidity and is potentially lethal es pecially when intestinal loss is extensive. The pathophysiology of short bo wel syndrome, its aetiology, prognosis and our understanding of the mechani sms of adaptation are reviewed. Management by a multi-disciplinary nutritio nal care team is advocated and should be directed to the maintenance of gro wth and development, the promotion of intestinal adaptation, the prevention of complications and the establishment of enteral nutrition. The choice of enteral feed, the role of drugs and the use of pro-adaptive nutrients and agents are discussed. Complications including cholestasis and catheter rela ted sepsis are outlined with strategies to reduce them. Finally the roles o f secondary surgical interventions including transplantation are discussed.