Treatment of Malabsorption in Short Bowel Syndrome, Especially in Patients Without a Colon
Acute intestinal failure due to short bowel syndrome severely impairs the gut's ability to absorb fluids and nutrients. Patients who lack a colon face the greatest challenge, as conventional fluid intake can worsen net fluid losses rather than correct them.
This protocol addresses malabsorption arising in the context of acute intestinal failure due to short bowel syndrome. The scenario has particular relevance for patients without a functioning colon, where impaired absorption makes standard oral hydration insufficient or counterproductive.
Management centres on sodium-rich oral rehydration fluid as the primary source of oral hydration, with specific protocol guidance on how and when fluids are taken in relation to meals.
The clinical targets are improved net intestinal absorption and a meaningful reduction in stool output.
References
- Patients with acute intestinal failure due to short bowel syndrome may benefit from sodium-rich fluids to improve net intestinal absorption.
- Patients with acute intestinal failure due to SBS, especially those without colon, should use oral rehydration fluid as their main source of oral hydration.
- It is also recommended that patients sip the fluids, and separate intake of liquids from intake of solids to prevent the rapid transit of solids and to improve the absorption.
- This creates an osmotic gradient, leading to water absorption and a reduction in stool output.