Short bowel syndrome: pathogenesis, clinical presentation and treatment

Abstract

Aim of review. To present basic information on the short bowel syndrome (SBS) Summary. Patients with the SBS are quite rare in practice of a clinician and, as a rule, require multidisciplinary approach. Most frequently disease manifests by malabsorption signs: diarrhea, weight loss, macro - and micronutrients deficiency, meteorism and abdominal pain. Nevertheless the spectrum and severity of signs considerably vary among patients. The aim of review was to highlight features of pathogenesis, clinical manifestations and treatment of SBS after small intestinal resection for various reasons. Localization and volume of resection, presence of the background affection of the small intestine and other abdominal organs involved in digestion process and also adaptation capacity of the remaining part of the gut fragment are the basic factors that determine severity of SBS and prognosis of patients. Conclusion. SBS prophylaxis is feasible and, taking into account of high disability and mortality rates of such patients, is essential both at preoperative stage, and during surgical intervention. Even at following of all modern guidelines only stabilization of the state is available in part of the SBS patients, while improvement of remaining small intestinal segment function will be impossible. Small intestinal transplantation may be considered as alternative treatment approach in these patients. Key words: short bowel syndrome, malabsorbtion syndrome, diarrhea, rehabilitation, parenteral nutrition.