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Canadian Journal of Gastroenterology
Volume 4 (1990), Issue 2, Pages 70-78
http://dx.doi.org/10.1155/1990/701014
Review

Short Bowel Syndrome: Intestinal Adaptation and Medical Therapy

WD Buie, OG Thurston, and Richard N Fedorak

Departments of Surgery and Medicine, University of Alberta, Edmonton, Alberta, Canada

Received 23 March 1989; Accepted 12 December 1989

Copyright © 1990 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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.