Short bowel syndrome (NORD)
Short bowel syndrome (NORD) exam links
Content Reviewers:Rishi Desai, MD, MPH
Contributors:Evan Debevec-McKenney, Charles Davis, MD
In short bowel syndrome, bowel is another word for the intestines.
It’s a condition that occurs when either the small intestine and/or the large intestine become physically shorter when a portion is removed by surgery, or functionally shorter, when a portion is damaged in a way that makes it nonfunctional.
This can lead to poor absorption of water and vital nutrients from food.
Normally, digestion begins when food is chewed and travels into the stomach where it’s dissolved by stomach acid, enzymes, and physical churning.
Then, it’s sent to the first portion of the small intestine, which is called the duodenum.
This is where more enzymes are added from the pancreas to digest macronutrients, including proteins, carbohydrates, and fats, while bile is added from the liver and gallbladder to help absorb fats.
It’s also where the absorption of some minerals like calcium, iron, and magnesium begins.
The next section is called the jejunum, and it has long projections on its surface, giving it a large surface area for absorption.
It plays the biggest role in the digestion and absorption of most nutrients, including the breakdown-products of macronutrients, zinc, water-soluble vitamins, and fat soluble vitamins, namely A, D, E, and K.
The third section is called the ileum, and it has tight intercellular junctions, allowing it to efficiently absorb fluid and begin concentrating the intestinal contents.
Unlike the jejunum, the ileum is also capable of undergoing structural and functional adaptations to compensate for the jejunum if needed.
The final portion is called the terminal ileum, and it absorbs vitamin B12 and bile salts which are recycled.
It ends with the ileocecal valve, which prevents intestinal contents from going into the large intestine too quickly and the backward flow of material.
The large intestine functions to absorb water, electrolytes like sodium and potassium, short-chain fatty acids, and bacteria within it produce vitamin K.
Since each part of the small intestine has a specialized function, as does the large intestine, the manifestations of short bowel syndrome depend on which portion is no longer functioning normally.
Short bowel syndrome (SBS) is a condition that occurs when a significant portion of the intestines is not functional or removed, either as a result of a surgical procedure or due to a congenital disorder. This leads to malabsorption of water and nutrients, and can cause a wide variety of symptoms depending on the section of bowel involved.
Symptoms of short bowel syndrome can include diarrhea, abdominal cramping and bloating, malnutrition, dehydration, and weight loss. The severity of symptoms can vary depending on the extent of the intestinal damage and the individual's ability to adapt and absorb nutrients from food. Diagnosis depends on the medical history, lab tests, and abdominal imaging, while treatment may include dietary adjustments, diarrhea medications, and total parenteral nutrition (TPN).