Short Bowel Syndrome

Not an actual patient.

Short bowel syndrome (SBS) is a serious and chronic malabsorption disorder.1,2,3

SBS results from physical loss and functional deficiency of the intestine, primarily due to surgical resection.1,2 Depending on remnant bowel anatomy and its residual function, patients with SBS may not be able to absorb sufficient nutrients through diet alone.3

Short bowel syndrome illustration

Epidemiology

The exact prevalence of SBS is not known due to under-reporting and the lack of reliable patient databases.1 It is estimated that 10,000 to 20,000 people in the U.S. have this condition.4 These figures may underestimate true prevalence since they are based on the number of patients receiving long-term parenteral nutrition and/or intravenous fluid support and do not include patients with well-tolerated resections who do not require this therapy.1,5

There are several indications for resection that may lead to SBS in adults and children.2,3,6,7,8 SBS may arise from congenital malformations or from physiologic or surgical causes, such as Crohn’s disease and trauma. (Note that many of these causes will be the indication for resection that led to SBS). Patients with SBS are a heterogenous group due to large variations in intestinal function and remnant bowel anatomy.

Pathophysiology

Loss of the structure and function of certain portions of the bowel can impact the hormones (such as GLP-1 and GLP-2) and the surface area needed for absorption.2,8 SBS is not just characterized by the length of the remaining bowel, but the clinical features indicating the inability to maintain nutritional, fluid, and/or electrolyte homeostasis while consuming a normal, healthy diet.1

After bowel resection surgery, the lining of the remaining intestine may change to absorb more nutrients and fluid through a natural process called intestinal adaptation.2,9,10 This process is encouraged by the presence of nutrients in the gut lumen and the release of gut-related hormones—notably GLP-1, GLP-2 and growth hormone. Gastrointestinal adaptation facilitates weaning patients from parenteral nutrition and IV fluid support. However, this process is highly variable and dependent on a patient’s clinical status and remnant anatomy.

Navigating SBS

Complications in patients with SBS may relate directly to their disease, to consequences of fluid/electrolyte imbalance and malnutrition, and to complications associated with parenteral nutrition.2,11,12,13 Along with physical limitations, many patients may be unable to work — especially those on home parenteral nutrition. Whatever the cause, SBS and the use of parenteral nutrition are associated with significant morbidity.

  1. O'Keefe SJD, Buchman AL, Fishbein TM, et al. Clin Gastroenterol Hepatol. 2006;4(1):6-10.
  2. Pironi L. Best Pract Res Clin Gastroenterol. 2016;30(2):173-185.
  3. Parrish CR and DiBiase JK. Gastroenterol Hepatol. 2017;13(10):600-608.
  4. Crohn's & Colitis Foundation. Short Bowel Syndrome and Crohn's Disease. March 2018. https://www.crohnscolitisfoundation.org/sites/default/files/2020-03/short-bowel-disease-crohns.pdf. Last accessed September 21, 2021.
  5. Massironi S, Cavalcoli F, Rausa E, et al. Dig Liver Dis. 2020;52(3):253-261.
  6. Pironi L, Arends J, Bozzetti F, et al. Clin Nutr. 2016;35(2):247-307.
  7. Tappenden KA. JPEN J Parenter Enteral Nutr. 2014;38(Suppl 1):14S-22S.
  8. Ou J, Courtney CM, Steinberger AE, et al. Nutrients. 2020;12(2):520.
  9. Misiakos EP, Macheras A, Kapetanakis T, et al. J Clin Gastroenterol. 2007;41(1):5-18.
  10. Weale AR, Edwards AG, Bailey M, et al. Postgrad Med J. 2005;81(953):178-184.
  11. Tappenden KA. JPEN J Parenter Enteral Nutr. 2014;38(Suppl 1):23S-31S.
  12. Carlsson E, Bosaeus I, Nordgren S. Clin Nutr. 2003;22(5):445-452.
  13. Messing B, Crenn P, Beau P, et al. Gastroenterology. 1999;117(5):1043-1050.
  14. Amiot A, Messing B, Corcos O, et al. Clin Nutr. 2013;32(3):368-374.

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Upcoming & Past Conferences in Gastroenterology

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United European Gastroenterology Week (UEGW), 2024

October 12 - 15, 2024 | Link to Event

Global congress for researchers from around the world to present their findings on gastroenterology and digestive health.

American College of Clinical Pharmacy (ACCP), 2024

October 12 - 15, 2024 | Link to Event

Annual event dedicated to excellence in clinical pharmacy practice, research, and education.

Academy of Managed Care Pharmacy Nexus (AMCP Nexus), 2024

October 14 - 17, 2024 | Link to Event

Annual event with more than 2,500 members and non-members of the AMCP to engage on the latest innovations and most intentional networking in managed care pharmacy.

American College of Allergy, Asthma & Immunology (ACAAI), 2024

October 24 - 28, 2024 | Link to Event

Global meeting featuring thought leaders from around the world focused on advancing patient care in allergy and immunology.

American College of Gastroenterology (ACG), 2024

October 25 - 30, 2024 | Link to Event

Premier event for clinicians and the general public about digestive disorders and the latest trends in GI technology and therapeutics.

North American Society For Pediatric Gastroenterology, Hepatology & Nutrition (NASPGHAN), 2024

November 6 - 9, 2024 | Link to Event

Annual forum for participants to learn about the latest advances in pediatric gastroenterology, hepatology, and nutrition, and to discuss current topics in clinical applications.

Advances in Inflammatory Bowel Diseases (AIBD), 2024

December 9 - 11, 2024 | Link to Event

An all-encompassing event providing real-world clinical education, case studies and new evidence-based approaches in IBD management.

European Society for Clinical Nutrition & Metabolism Congress (ESPEN), 2024

September 7 - 10, 2024

Annual global congress dedicated to clinical nutrition and metabolism, including basic and clinical research, education, and organization of consensus statements about clinical care.

Digestive Disease Week (DDW), 2024

May 18 - 21, 2024

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European Crohn's and Colitis Organisation

February 21 - 24, 2024

Annual global congress structured around basic science, traditional medicine and clinical sessions given by some of the world's top GI specialists.

Crohn's & Colitis Congress (CCC), 2024

January 25 - 25, 2024

Annual conference for a multidisciplinary community of practitioners and researchers focusing on inflammatory bowel disease (IBD) by pairing best practices in clinical care with innovative research.

Advances in Inflammatory Bowel Diseases (AIBD), 2023

December 14 - 16, 2023

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American College of Gastroenterology (ACG), 2023

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United European Gastroenterology Week (UEGW), 2023

October 14 - 17, 2023

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  • Corticosteroid-Free Remission in Anti-TNF-Failed Crohn’s Disease Patients Treated With Vedolizumab as Second-Line Biologic Therapy: A Real-World Data Review
  • Vedolizumab Long-Term Treatment Persistence And Safety – Results From A Multinational Extended Access Programme Study

North American Society For Pediatric Gastroenterology, Hepatology & Nutrition (NASPGHAN), 2023

October 4 - 7, 2023

Annual forum for participants to learn about the latest advances in pediatric gastroenterology, hepatology, and nutrition, and to discuss current topics in clinical applications.

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  • Teduglutide Long-Term Safety and Effectiveness for a Pediatric Cohort Enrolled in an Observational, Prospective, Multi-Center Short Bowel Syndrome and Intestinal Failure Registry

Medication Resources

Gattex®

(teduglutide)