Short bowel syndrome.

Extensive anatomical or functional loss of small bowel results in a spectrum of metabolic and physiological disturbance known as the short bowel syndrome (SBS). This is most commonly encountered in the newborn infant with congenital or acquired loss of small bowel. Since there is inadequate absorptive capacity, enteral feeding initially results in diarrhoea. Management is therefore aimed at promoting and maintaining growth in the expectation that subsequent adaptational changes in the residual bowel will eventually allow full enteral feeding to be established. When there is insufficient residual small bowel, home parenteral feeding may permit long term survival with a good quality of life. Although intravenous nutrition has transformed the prognosis for patients with short bowel syndrome, complications associated with this treatment represent an important cause of morbidity and mortality.