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.