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         Short Bowel Syndrome:     more detail
  1. The Official Patient's Sourcebook on Short Bowel Syndrome: A Revised and Updated Directory for the Internet Age by Icon Health Publications, 2002-08
  2. Diarrhea: Defecation, Lactose intolerance, Short bowel syndrome, Hyperthyroidism, Coeliac disease
  3. Short bowel syndrome: New therapeutic approaches (Current problems in surgery) by Douglas W Wilmore, 1997
  4. Mrs. Smith: the boarding school enemas (Stories of J. G. Knox) by J. G. Knox, 2008-10-20

1. Discovery Health Short Bowel Syndrome
short bowel syndrome is a condition caused by surgery that removes part of the small intestine, such as an ileostomy.
http://health.discovery.com/diseasesandcond/encyclopedia/2414.html

2. EMedicine - Short Bowel Syndrome : Article By Carmen Cuffari, MD
short bowel syndrome Few conditions in pediatric gastroenterology pose as great a challenge as short bowel syndrome (SBS). short bowel syndrome.
http://www.emedicine.com/ped/topic2088.htm
(advertisement) Home Specialties CME PDA ... Patient Education Articles Images CME Patient Education Advanced Search Link to this site Back to: eMedicine Specialties Pediatrics Gastroenterology
Short Bowel Syndrome
Last Updated: April 11, 2003 Rate this Article Email to a Colleague Synonyms and related keywords: SBS, short-bowel syndrome, total parenteral nutrition, TPN AUTHOR INFORMATION Section 1 of 10 Author Information Introduction Clinical Differentials ... Bibliography
Author: Carmen Cuffari, MD , Assistant Professor, Department of Pediatrics, Division of Gastroenterology/Nutrition, Johns Hopkins University Editor(s): Jorge Vargas, MD , Professor, Department of Pediatrics, Division of Pediatric Gastroenterology, University of California at Los Angeles School of Medicine; Robert Konop, PharmD , Clinical Assistant Professor, Department of Pharmacy, Section of Clinical Pharmacology, University of Minnesota; David Piccoli, MD , Chief, Division of Gastroenterology and Nutrition, Children's Hospital of Philadelphia; Professor, Department of Pediatrics, University of Pennsylvania; Steven Schwarz, MD

3. ABCNEWS.com : Making Do With Less: Short Bowel Syndrome
Information, description, diagnosis, symptoms and treatment.
http://abcnews.go.com/sections/living/Healthology/HOshortbowel_syndrome020906.ht
var SectionID="Living"; var SubsectionID="Healthology"; var NameID="HOshortbowel_syndrome020906"; September 6, 2002 FEATURED SERVICES RELATIONSHIPS SHOPPING DOWNLOADS WIRELESS ... FREE HEADLINE FEED INTERACT BOARDS CHAT NEWS ALERTS CONTACT ABC Making Do With Less: Short Bowel Syndrome
Uma Sundaram, MD, University of Rochester School of Medicine
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Health Library:
Select a Health Topic ADD/ADHD Allergy Alternative Medicine Arthritis Asthma Beyond Dieting Body Aches and Pains Breast Cancer Cancer Awareness Cardio Health Children's Health Contraception COPD/Emphysema Dental Health Diabetes Elder Care Emergency Room Epilepsy Eye Care Fertility Fitness Gastrointestinal Health Hair Loss Headache Healthcare Today Healthy Aging HIV and AIDS Infectious Diseases Kidney Health Leukemia Liver Health Lung Cancer Lymphoma Multiple Sclerosis Men's Health Mental Health Nutrition Osteoporosis Sexual Health Skin Health Sleep Disorders Special Events Stroke Surgeries and Procedures Teen Health Thyroid Health Urologic Health Vascular Disease Women's Health Measuring anywhere from 15 to 20 feet, with a total surface area sometimes equivalent to that of a football field, it's hard to believe just how big the small intestine really is. We require much of our small intestine to comfortably absorb enough water, vitamins, and other food nutrients to stay healthy. But, for those who have had at least half their small intestine removed during surgery, absorbing nutrients and controlling the flow of fluid and food through the digestive tract can become very difficult. The problems associated with a shortened small intestine are known as short bowel syndrome, and the effects of this syndrome can range from mild to life threatening. Below, Dr. Uma Sundaram, Professor of Internal Medicine at University of Rochester School of Medicine, talks about the characteristics of short bowel syndrome, and how to treat it.

4. Short Bowel Syndrome.
short bowel syndrome refers to the malabsorption of food nutrients due to disease or surgical removal of parts of the small intestine. short bowel syndrome.
http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Short_bowel_syndr

5. Short Bowel Syndrome
short bowel syndrome. By Lori S. Brizee MS RD CD, Clinical Dietitian, Children's Hospital and Regional Medical Center, Seattle, Washington. Definition. Early Nutritional Support. Long Term Nutritional Support Nutrient Deficiencies and Outcome for short bowel syndrome. Definition of short bowel syndrome. short bowel syndrome (SBS) is defined as
http://depts.washington.edu/growing/Assess/SBS.htm
Short Bowel Syndrome
By Lori S. Brizee MS,RD,CD,
Clinical Dietitian, Children's Hospital and Regional Medical Center,
Seattle, Washington Definition
Early Nutritional Support

Long Term Nutritional Support
Nutrient Deficiencies ... Definition of Short Bowel Syndrome Short Bowel Syndrome (SBS) is defined as malabsorption resulting from anatomical or functional loss of a significant length of the small intestine. Most commonly this occurs after bowel resection in the newborn period (i.e., secondary to necrotizing enterocolitis ). The amount of bowel that must be lost to produce malabsorption is variable and depends on which section(s) is/are lost, and whether the ileocecal valve is preserved. The normal length of small intestine is approximately 300 to 850 cm for an adult, 200 to 250 cm for an infant over 35 weeks gestation, and approximately 100 to 120 cm for a premature infant, less than 30 weeks gestation. Loss of greater than 80% of the small bowel is associated with increased requirement for parenteral nutrition support, and decreased overall survival. When the ileocecal valve is lost, the resulting bacterial contamination of the small intestine mandates more small intestine for tolerance of oral/enteral feeding. The small intestine consists of the duodenum, jejunum and ileum. The majority of carbohydrate and protein absorption takes place in the duodenum and jejunum. Fats and fat soluble vitamins, however are absorbed in the ileum. Bile salts are excreted from the liver into the duodenum; these are required for the absorption of long chain fatty acids and fat soluble vitamins in the ileum. Vitamin B12 binds to intrinsic factor (produced in the stomach) and is also absorbed in the terminal ileum. Fluids and electrolytes are predominantly absorbed in the ileum and in the colon. When the duodenum and/or jejunum are resected, the ileum can largely adapt to perform their absorptive functions. However, the duodenum and jejunum cannot adapt to perform the functions of the ileum. Thus, resection of the duodenum or jejunum is generally much better tolerated than resection of the ileum.

6. Short Bowel Syndrome - ICQ Interest Groups - ICQ.com
ICQ interest group about this disease.
http://web.icq.com/groups/browse_folder?tid=6329

7. Necrotizing Enterocolitis And Short Bowel Syndrome
Information, risk factors, presentation, management of these disease.
http://www.naspgn.org/sub/NECROTIZING_ENTEROCOLITIS_AND_SHORT_BOWEL_SYNDROME.htm
Chapter quoted in part from:
Bentley D, Lifschitz C, Lawson M. Pediatric Gastroenterology and Clinical Nutrition. 2001.
ReMedica Publishing, London U.K. with permission.
Necrotizing Enterocolitis and Short-Bowel Syndrome
Necrotizing enterocolitis
This acute gastrointestinal disorder was first described in the German literature in 1825 [1], but is still something of an enigma. Despite years of investigation, the etiology remains unclear, and accepted prevention and treatment strategies are lacking. Necrotizing enterocolitis (NEC) predominantly affects premature infants; less commonly (10%), term newborns, and, rarely, severely debilitated children. There have been instances of nursery epidemics. Some centers see this problem affecting as many as 8% of newborns born weighing less than 1.5 kg, while other units have a very low incidence of only 0.3% among their premature babies. Several countries, for example Switzerland and Scandinavia, have a very low incidence. In a study involving 52 centers in Japan [2], the incidence was only 0.3%. In the USA, the incidence is 2.4 in 1000 live births [3,4]. NEC is the commonest neonatal gastrointestinal emergency in both the UK and America.
Risk factors
Susceptibility to NEC is increased by the following:
  • Extreme prematurity [5] Birth weight under 2.0 kg

8. Nursing Spectrum- Career Fitness Online
Nurses' knowledge and information about the care of patients with this syndrome and children who endure prolonged hospitalization.
http://nsweb.nursingspectrum.com/ce/ce97.htm
Short Bowel Syndrome and the
Hospitalized Pediatric Patient
Janet Ashmore, RN, BS
  • Describe the primary causes and diagnostic criteria for SBS. Identify three disease-related complications associated with SBS. List three nursing interventions appropriate for a pediatric patient during a prolonged hospitalization.
Although the exact mechanism for this change is still a mystery, we do know that the process leads to an increase in surface area of the remaining bowel. Clinical Snapshot In any event, pediatric patients with SBS are at risk for numerous complications. These babies have frequent episodes of diarrhea and fluid and electrolyte imbalances. Inadequate vitamin intake can cause cracked skin at the corners of their mouths and sore tongues from riboflavin deficiency, or bleeding because of a vitamin K deficiency. Anemia secondary to the problems of malnutrition may occur. And patients who require a central venous line (CVL) are at risk for developing life-threatening sepsis. Other chronic conditions include changes in bacterial intestinal flora, including bacterial overgrowth, chronic cholestatis, and subsequent occurrence of parenteral nutrition (PN)-related liver disease, which can be life-threatening. The most common cause of death in these children is, in fact, liver failure as a consequence of the PN required during the first years of treatment.

9. Free Online CME: Short Bowel Syndrome: Etiology, Pathophysiology And Management
Earn up to 1 hour of Category 1 CME credit by completing this free online learning activity. Participants will read an article and answer related questions. List the most frequent causes of the
http://www.clevelandclinicmeded.com/selected_topics/shortbowel/intro1.asp
Case 2: Short Bowel Syndrome: Etiology, Pathophysiology and Management
Activity Release Date: 9/27/2001
Activity Renewal Date: 9/27/03
Activity Expiration Date: 9/27/05 CME Objectives Short Bowel Syndrome: Etiology, Pathophysiology and Management Upon completing this activity, the participant will be able to:
  • List the most frequent causes of the short bowel syndrome and describe the physiologic consequences of this condition. Discuss the potential long-term complications of extensive intestinal resection. Recommend dietary modification, fluid, electrolyte, mineral, and vitamin supplementation according to extent and location of intestinal resection. Identify the medications which may be used to optimize absorption and minimize secretion in patients with short bowel syndrome.
  • Authors: Douglas L. Seidner, MD

    10. MedlinePlus Medical Encyclopedia: Short Bowel Syndrome
    Illustrations, definition, incidence, risk factors, diagnosis, treatment and prognosis of this disease.
    http://www.nlm.nih.gov/medlineplus/ency/article/000237.htm
    @import url(http://www.nlm.nih.gov/medlineplus/images/advanced.css); Skip navigation
    Medical Encyclopedia
    Other encyclopedia topics: A-Ag Ah-Ap Aq-Az B-Bk ... Z
    Short bowel syndrome
    Contents of this page:
    Illustrations
    Digestive system Digestive system organs Alternative names Return to top Small intestine insufficiency Definition Return to top Short bowel syndrome is condition of nutritional malabsorption related to the surgical removal or disease of a large portion of the small intestine. Causes, incidence, and risk factors Return to top When areas of the small intestine are removed surgically, there may not be enough surface area left in the remaining bowel to adequately absorb nutrients from food. This condition is particularly likely to develop when one-half or more of the bowel is removed during surgery. Risk factors include diseases of the small intestine that may require surgical intervention such as regional enteritis or Crohn's disease Necrotizing enterocolitis is a common cause of this syndrome in infants.

    11. Short Bowel Syndrome
    Home Digestive Diseases AZ List of Topics and Titles short bowel syndrome. short bowel syndrome. Diarrhea is the main symptom of short bowel syndrome.
    http://digestive.niddk.nih.gov/ddiseases/pubs/shortbowel/
    Email To A Friend Home Digestive Diseases A-Z List of Topics and Titles : Short Bowel Syndrome
    Short Bowel Syndrome
    Short bowel syndrome is a group of problems affecting people who have had half or more of their small intestine removed. The most common reason for removing part of the small intestine is to treat Crohn's disease. Diarrhea is the main symptom of short bowel syndrome. Other symptoms include cramping, bloating, and heartburn. Many people with short bowel syndrome are malnourished because their remaining small intestine is unable to absorb enough water, vitamins, and other nutrients from food. They may also become dehydrated, which can be life threatening. Problems associated with dehydration and malnutrition include weakness, fatigue, depression, weight loss, bacterial infections, and food sensitivities. Short bowel syndrome is treated through changes in diet, intravenous feeding, vitamin and mineral supplements, and medicine to relieve symptoms. Additional Information on Short Bowel Syndrome The National Digestive Diseases Information Clearinghouse collects resource information on digestive diseases for the Combined Health Information Database (CHID). CHID is a database produced by health-related agencies of the Federal Government. This database provides titles, abstracts, and availability information for health information and health education resources.

    12. Short Bowel Syndrome
    0 Then % Email To A Friend. Home Digestive Diseases AZ List of Topics and Titles short bowel syndrome. short bowel syndrome short bowel syndrome. short bowel syndrome. short bowel syndrome
    http://www.niddk.nih.gov/health/digest/summary/shortbo/shortbo.htm
    Email To A Friend Home Digestive Diseases A-Z List of Topics and Titles : Short Bowel Syndrome
    Short Bowel Syndrome
    Short bowel syndrome is a group of problems affecting people who have had half or more of their small intestine removed. The most common reason for removing part of the small intestine is to treat Crohn's disease. Diarrhea is the main symptom of short bowel syndrome. Other symptoms include cramping, bloating, and heartburn. Many people with short bowel syndrome are malnourished because their remaining small intestine is unable to absorb enough water, vitamins, and other nutrients from food. They may also become dehydrated, which can be life threatening. Problems associated with dehydration and malnutrition include weakness, fatigue, depression, weight loss, bacterial infections, and food sensitivities. Short bowel syndrome is treated through changes in diet, intravenous feeding, vitamin and mineral supplements, and medicine to relieve symptoms. Additional Information on Short Bowel Syndrome The National Digestive Diseases Information Clearinghouse collects resource information on digestive diseases for the Combined Health Information Database (CHID). CHID is a database produced by health-related agencies of the Federal Government. This database provides titles, abstracts, and availability information for health information and health education resources.

    13. Intestinal Disease Foundation - Short-Bowel Syndrome
    short bowel syndrome short bowel syndrome (SBS) occurs whenever the functions of the small bowel have been removed from the body by disease or surgery.
    http://www.intestinalfoundation.org/library/short.shtml

    Useful Words

    Irritable Bowel Syndrome

    Diverticular Disease

    Short-Bowel Syndrome
    ... Children and IBD
    Short Bowel Syndrome
    Short bowel syndrome (SBS) occurs whenever the functions of the small bowel have been removed from the body by disease or surgery. The normal small bowel varies in length between 10 and 28 feet and is divided into three sections. The first section is the duodenum and is located just after the stomach. The duodenum is relatively short, measuring only about 10-12 inches. The next section is the jejunum, which is the largest but not the longest section. The jejunum comprises only 2/5 of the rest of the small intestine but is the largest section because its many folds give it an increased diameter. The final 3/5 of the small bowel is the ileum.
    The level of difficulty experienced by a patient with SBS is often determined by which sections are affected. One half of the small bowel can be removed without significant disability resulting, especially if the ileum is not involved. However, the more intestine removed, the greater the disability a patient will experience. The entire jejunum can be removed without much disability except for lactose intolerance. The ileum can compensate for all the losses of the jejunum except the lactose deficiency. Removal of the ileum accounts for most of the problems seen in short bowel syndrome since it is responsible for the absorption of fats, bile salts, and B12.
    Causes
    back to top

    Signs and Symptoms Signs and symptoms of SBS vary greatly depending on how much of the small bowel is lost and how long the malabsorption (inadequate absorption of nutrients) has been allowed to continue. Generally speaking, weight loss, diarrhea, abdominal bloating, fatigue, and steatorrhea (fat in the stool) are present in SBS. If the malabsorption is long-standing, other symptoms may appear that relate to the nutrient that is deficient.

    14. Short Bowel Syndrome (SBS)
    short bowel syndrome (SBS) The short bowel syndrome occurs from massive small intestinal resection leaving less than 200 cm (6.5 feet) of small bowel.
    http://www.um-pediatric-surgery.org/new_070198/new/Library/Short Bowel Syndrome.
    Short Bowel Syndrome (SBS) The short bowel syndrome occurs from massive small intestinal resection leaving less than 200 cm (6.5 feet) of small bowel. In children, however, a length which is less than 30% of the normal length for age is the generally accepted definition of SBS. Etiologies range from a loss due to congenital anomalies, loss from necrotizing enterocolitis , resections due to strangulation of the intestine (volvulus) or from extensive resections for inflammatory bowel disease . Approximately 10 to 20,000 patients are cared for each year with SBS in the United States. Severity of the loss of intestine has generally been associated with a loss of excess bowel length or loss of the ileocecal valve. Over the past decade, it has been better appreciated that the severity of SBS is most correlated with the absolute function of the intestine. Many individuals with 40 cm of small bowel may eventually adapt and transition off TPN. More important is the need for normal motility of the stomach and small intestine, as well as the overall injury that the remaining intestine incurred. Figure above shows the various etiologies, and approximate frequencies, of SBS in infants and children.

    15. SciELO Error
    Scientific article about incidence and treatment of hypomagnesemia in patients with extensive small bowel resection.
    http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-318020000006000

    16. Frequently Asked Questions - Assuring Pediatric Nutrition In The Community
    Assuring Pediatric Nutrition in the Community. FREQUENTLY ASKED QUESTIONS Specific Diagnoses short bowel syndrome.
    http://depts.washington.edu/nutrpeds/faq/diagnosis/sbs.htm
    Assuring Pediatric Nutrition in the Community
    FREQUENTLY ASKED QUESTIONS:
    Specific Diagnoses - Short Bowel Syndrome
    Does anyone know of a support group for parents of children surviving necrotizing enterocolitis (NEC) with short bowel syndrome (SBS)? There does not appear to be a specific support group for children who had NEC as infants resulting in SBS. However, there is a foundation called the Oley Foundation which is national and is a support group for kids on long term TPN. Within this group, there are many children who have SBS resulting from NEC. The Oley foundation has a newsletter as well. The number for the Oley foundation is 1-800-776-OLEY. After calling this number, the family will be directed to the closest group in their region. Most of the families involved have children with SBS who had NEC as infants. There is an annual conference for the families where MD's and RD's present the newest research and treatments for sequlae from SBS. Return to Top of Page Return to Home Page Return to Frequently Asked Questions Table of Contents
    Back to PKU
    ... Forward Prematurity This page was last updated

    17. THE MERCK MANUAL, Sec. 3, Ch. 30, Malabsorption Syndromes
    short bowel syndrome. Infection And Infestation. short bowel syndrome short bowel syndrome is often the result of extensive intestinal resection
    http://www.merck.com/pubs/mmanual/section3/chapter30/30g.htm
    This Publication Is Searchable The Merck Manual of Diagnosis and Therapy Section 3. Gastrointestinal Disorders Chapter 30. Malabsorption Syndromes Topics [General] Carbohydrate Intolerance Celiac Disease Tropical Sprue ... Infection And Infestation
    Short Bowel Syndrome
    (Inadequate Absorptive Surface)
    Short bowel syndrome is often the result of extensive intestinal resection. Another cause is jejunoileal bypass for morbid obesity. An inadequate absorptive surface results in an inadequate caloric intake and malabsorption of B and other vitamins, which in turn can result in severe malnutrition with neurologic deficits. Severe Ca and Mg deficiency can lead to encephalopathy, tetany, and convulsions. Carbohydrate can escape the small bowel to be fermented by colonic bacteria to L- and D-lactic acid. Because the latter is not readily metabolized on reaching the blood, the resulting D-lactic acidosis can cause irritability, bizarre neurologic dysfunction, or a frankly encephalopathic state. Such GI loss of electrolytes can cause hypokalemia, and TPN can cause hypophosphatemia, which can cause muscle paralysis.

    18. THE MERCK MANUAL, Sec. 3, Ch. 30, Malabsorption Syndromes
    short bowel syndrome. short bowel syndrome (Inadequate Absorptive Surface). short bowel syndrome is often the result of extensive intestinal resection.
    http://www.merck.com/mrkshared/mmanual/section3/chapter30/30g.jsp

    19. Noguts Country Club
    Association providing information, support by mailing list, newsletter and contact by email to patients with a short bowel syndrome.
    http://www.noguts.us
    Our Mission at the Noguts Country Club
    Trying to help others with Short Bowel Syndrome along the way.
    We have put the discussion board Online Please DO NOT SPAM
    For all our friends
    http://www.noguts.com
    We have a NEW PROGRAM that gives 10% to a person with SBS. It is called the
    Noguts Discount Club

    Check it out: GO HERE There is a Question Form on the Discount Club Web Site if you need to ask us about it. We feature Stanley Home Products and Fuller Brush Products. Also Please check out the web site at:
    www.othellosmith.org

    Jennifer has some Great Information you should read. Be sure to check out the story about Christian . His outlook is GREAT!
    Who We Are
    Hi and welcome to The No Guts Country Club. My name is Jim, I live in Fort Myers, Fl, just so you will know I am a real person. Every thing I say is from my experience in the last eleven years with Short Bowel Syndrome, in fact I have what is called Extreme Short Bowel Syndrome. I have " about " 12 inches of active small intestine and

    20. DeAndre's Battle With NEC And Short Bowel Syndrome
    Parents of a child with short bowel syndrome and needing total parenteral nutrition, write their story.
    http://www.deandrevaughn.com/
    Welcome! DeAndre's Page Our little miracle!!!!! This Page is For our Son DeAndre Torrese. We Love you Baby Boy! DeAndre On December 18,2002 One hour after he was born.
    Two tiny feet That wave in the air Two tiny hands That grab at your hair Cute bottom for patting Adorable face A bundle of joy To love and embrase Precious one, So small, So sweet,
    Dancing in On Angel feet Straight from heaven's Brightest star
    What a miracle you are!
    Please remember to go to the contact us page and sign his guest book! It will mean so much to us!
    please click on the flower below to visit a very special little girls web page. Her name is Stephanie and she has short bowel syndrome as well. Please visit her page! DeAndre on his first Halloween! Oct. 31st, 2003

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