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.