Treatment of Malabsorption in Short Bowel Syndrome with High Faecal Output

This protocol addresses malabsorption in patients with short bowel syndrome (SBS) who have high faecal output — defined as faecal output exceeding 2 L per day. This is a clinically significant threshold at which targeted medical management is warranted.

Clinical Scenario

Short bowel syndrome with high faecal output (faecal output greater than 2 L/day). This level of output reflects substantial intestinal fluid and electrolyte loss, particularly sodium, and is the defining feature that guides the treatment approach in this protocol.

Treatment Goal

Reduction in faecal wet weight and sodium excretion.

Treatment Approach (Overview)

The approach involves acid-suppressive therapy to address hypersecretion and reduce faecal wet weight and sodium excretion — particularly relevant in the early postoperative period after bowel resection.

The full structured regimen — including specific agents, sequencing, and clinical decision points — is available via the protocol below.

Instant Access to Structured Evidence-Based Regimens

References

In patients with short bowel syndrome and high faecal output, the use of H2-receptor antagonists or proton pump inhibitors may be effective in reducing faecal wet weight and sodium excretion.

Treatment of hypersecretion in patients with SBS with H2-receptor antagonists or proton pump inhibitors can be used to reduce faecal wet weight and sodium excretion, especially during the first 6 months after surgery and especially in those SBS patients with a faecal output greater than 2 L/day.

Two studies demonstrated their efficacy in reducing ostomy output in SBS patients, with reductions in faecal wet weight and sodium excretion in the range of 20%–25%.

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