| Summary: | Short bowel syndrome is a clinical entity, a consequence of
significant loss of intestinal surface area, and manifests a variable picture of
diarrhea, steatorrhea, malabsorprion and weight loss. Previously high mortality
rates have been reduced by the early use of parenteral nutrition and have
subsequently resulted in increased survival and prevalence of the condition.
Ultimate patient survival is dependent on the intrinsic adaptive ability of residual
intestine and this, in turn, is dependent upon length, type, functional state and
the presence or absence of an ileocecal valve. The mechanisms of intestinal
adaptation are not entirely understood; however, they can be grouped into three
broad categories: luminal nutrition, hormonal factors, and pancreaticobiliary
secretion. Medical treatment of short bowel syndrome remains supportive and
centres around the control of three pathophysiological defects: decreased intestinal
transit time, gastric hypersecretion, and reduced functional mucosal surface
area.
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