Short Bowel Syndrome (SBS) | Treatments

What are the treatment options for short bowel syndrome?

Nutritional management

Since your child's intestines aren’t able to absorb the nutrients the body needs, they may need to get those nutrients through either parenteral nutrition (PN) or enteral nutrition (EN).

With PN, a special nutritional formula is delivered directly into your child's bloodstream through intravenous feeding (IV). This formula is carefully developed by your child's registered dietician and calibrated to their body’s precise energy needs. Delivering nutrients straight to your child's bloodstream means that it can bypass the digestive system altogether. Most children requiring PN are given the solution over the course of 12 to 24 hours on a daily basis. If your child requires PN for longer-term support, we'll gradually decrease the length of each session.

If your child is receiving EN, a special nutritional formula through a tube delivers necessary nutrients. There are two ways we feed children through EN:

  • gastrostomy tube (G-tube) - passed through an opening into your child's stomach
  • jejunostomy tube (J-tube) - passed through an opening into a portion of her small intestine

EN can be used to prepare the support your child’s intestine while recovering from a surgical procedure.

Medicine

Your child's doctor might prescribe medications to help manage your child's SBS and supplement nutritional intake. Some of these might include:

  • imodium: used to control diarrhea by giving your small intestines more time to absorb water and nutrients
  • ursodeoxycholic acid: a naturally-occurring bile acid that is used to dissolve and prevent cholesterol gallstones and to treat primary biliary cirrhosis, a disease of the liver
  • acid blocking agents: including H2 blocker and proton-pump inhibitors
  • vitamin supplements: either multivitamins or single nutrient supplements
  • oral antibiotics: to prevent or treat small bowel bacterial overgrowth
  • Omegaven: a unique fish oil-based emulsion developed by Mark Puder, MD, that appears to help prevent and improve liver disease resulting from total PN.

Surgery

Sometimes it's possible to surgically reshape the small intestine to increase the surface area of the intestines and prolong the amount of time it takes for food to move through, giving the intestines more time to extract nutrients. The serial transverse enteroplasty procedure (STEP) reshapes the small intestine in order to expose more usable surface area and create a narrower space, which keeps food moving through your child's digestive tract at an appropriate pace, carrying bacteria out of the body along with the rest of the body's waste.

Transplant

Many children do quite well with IV feedings, but sometimes complications arise that make it no longer an option. In this case, your child might be a candidate for an intestinal transplant. There are a few different types of intestinal transplants, including:

  • intestinal transplant
  • intestinal/liver transplant
  • multivisceral transplant (the intestines are replaced, along with the liver and/or spleen, and sometimes the stomach)