digestive disorders
Short Bowel Syndrome
Treatment of Short Bowel Syndrome
Total parenteral nutrition (TPN) Sometimes antidiarrheal medications, nutritional supplements, and proton pump inhibitors Immediately after surgery, when diarrhea is typically severe, doctors give intravenous fluids to replace fluid and electrolyte losses and usually also give intravenous feedings. These feedings, called Intravenous Feeding (TPN), contain all necessary nutrients, including proteins, fats, carbohydrates, vitamins, and minerals. As people recover and their stool output lessens, they are slowly given fluids by mouth. People who have had a large amount of small intestine removed (such as those with less than 3 feet [about 1 meter] of remaining small intestine) and those who continue to have excessive fluid and other nutrient losses require TPN for life. Other people eventually tolerate food by mouth. The recommended diet usually has more fat and protein than carbohydrate. Small, frequent meals are better than fewer, large ones. People 1 year of age and older who need TPN may be given injections of a medication calledteduglutide. This medication may help reduce the amount of TPN people need. People who have diarrhea after meals should take antidiarrheal medications such asloperamide1 hour before eating.Cholestyraminecan be taken with meals to reduce diarrhea caused by malabsorption of bile acid. Most people should take supplemental vitamins, calcium, and magnesium. Because people with short bowel syndrome often have excess stomach acid, most people also take an acid-blocking medication, such as a proton pump inhibitor. Some people require monthly injections of vitamin B12. Small Intestine Transplantation is an alternative for people who do not adapt to their short bowel and who cannot tolerate long-term TPN. 