There is no reliable cure for SBS at this time. Managing
SBS requires a thorough understanding of normal digestion and nutrient
absorption, and knowledge about the effect that resection of the small
intestine has on these processes. The prognosis for patients with SBS
is largely determined by the extent and location of the excised intestine,
and on the condition of the remaining intestine. Patients with limited
small intestine resections generally have a good prognosis with careful
follow-up and management of their specific nutritional needs. Patients
with a more extensive resection have more difficult management problems
and their long-term care must be monitored more closely. Even in this
group of patients, the rate of survival and quality of life have been
steadily improving, largely due to growing experience with long-term TPN
and more sophisticated methods of assessing nutritional needs.
Although most patients will require TPN immediately
after surgery, intestinal adaptation
will allow many patients to transition to a modified diet taken orally,
along with supplemental vitamins and minerals, and medications. A better
understanding of how intestinal adaptation is initiated by the body may
eventually lead to the development of drugs that can accelerate this process
in patients with SBS.
Surgical techniques
developed to treat SBS are designed to maximize the absorptive surface
area and slow transit time through the intestines. They are still controversial,
and not widely available. However, if these procedures are proven to be
successful in clinical trials, they will likely provide the foundation
for surgical therapy in the future.
Even though small intestine
transplantation has evolved from being an experimental procedure to
one that is accepted as an option for treating SBS, it is still reserved
for the most severe cases. Future advances in immunosuppressive therapy
may increase the use and success of transplantation, thus making it a
viable option for a wider range of patients with SBS.
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.
