Beyond Basics
Factors Influencing Digestive Process In A Patient With SBS
Intestinal Adaptation
Following surgical resection, the remaining small intestine
adapts by increasing its ability to absorb nutrients. The villi increase
in height, cellular turnover in the villi increases, and the crypts become
deeper. These physical changes increase the surface area of the remaining
small intestine.
Figure 8 –
Comparison of Normal to Adapted Villi
As a result of intestinal adaptation, the absorption
of nutrients increases by up to fivefold after resection. This gradually
results in improved digestion and absorption. Because the ileum has a
greater capacity for adaptation than the jejunum, resection of the jejunum
is better tolerated than resection of the ileum.
Nutrients in the lumen of the small intestine are essential
for the adaptation process to take place. Patients with SBS are therefore
encouraged to begin taking food orally as soon as possible. If all nutrients
are provided parenterally, some studies suggest that there may be a significant
amount of atrophy in the mucosa of the small intestine.
Intestinal adaptation is not completely understood.
It begins immediately after intestinal resection and may continue for
up to two years. The small intestine secretes numerous substances that
may also stimulate intestinal adaptation under certain extreme conditions,
and this idea is being explored. In the future, a better understanding
of the underlying mechanisms of intestinal adaptation may suggest new
ways to stimulate this process by using innovative treatments.
This information
is provided as a general educational service
and is not intended to recommend any particular treatment plan
or to replace the advice of physicians. It is important that patients
seek and rely on the advice of a healthcare professional
about their individual medical conditions.
