What are the nutritional concerns in patients with short bowel syndrome?
- Loss of bowel surface puts the patient at great risk for dehydration and malnutrition. The small bowel averages 600 cm in length and absorbs approximately 10 L/day of ingested and secreted fluids.
- A patient may tolerate substantial loss of small bowel, although preservation of less than 2 feet with an intact colon and ileocecal valve or less than 5 feet in the absence of the colon and ileocecal valve may make survival impossible when just the enteral route of nutrition is used.
- In addition, the loss of the distal ileum precludes absorption of bile acids and vitamin B 12 .
- Remaining bowel, especially ileum, may adapt its absorptive ability over several years, but underlying disease may hamper this process.
