Short bowel syndrome

The short bowel syndrome is a symptom complex that occurs in adults who hav e less than 200 cm of jejunum-ileum remaining after intestinal resection. S imilar symptoms are observed in infants and children following massive bowe l resection or congenital anomalies and in individuals with longer segments of intestine with severe mucosal disease, Initial care should focus on a t horough excision of nonviable bowel, an exact measurement of the remaining viable bowel, placing all intestine in continuity at the initial or subsequ ent operation, and controlling initial food intake. With time, adaptation o f the remnant intestine occurs, and absorptive function may be maximized by enhancing the enteral diet and minimizing parenteral nutrition. Growth fac tors and specialized nutrients may also enhance this process. Intestinal tr ansplantation should be considered in selected individuals with the short b owel syndrome who fail intestinal rehabilitation protocols.