Extensive loss of small bowel in all age groups has dramatic
consequences on the lifestyle of the patient and the whole family
and is accompanied by significant morbidity and mortality. All
patients need nutritional and medical support and some of them
remain dependent on long-term parenteral therapy. Recurrent
surgical interventions or even intestinal transplantation may be
necessary. However, the intestinal tract exhibits an astonishing
ability to compensate for an extensive loss of small bowel.
Adaptation to the new situation takes place with time by structural
and functional changes resulting in an increased surface area with
improved digestive and absorptive capacity. This process, however,
differs markedly among individual patients depending on the
remaining length and functional quality of small bowel. Mechanisms
supporting, and complications delaying, the adaptation process have
been studied extensively over the past decades. This review
presents a survey of incidence, etiology, and consequences of
extensive loss of small bowel. A short description of the normal
digestive and absorptive function of the gastrointestinal tract and
the pathophysiological consequences in short bowel cases is
followed by discussing the current field of basic research,
presenting today's medical and surgical treatment modalities and
the related results in patients with SBS. Most of the data are
derived from animal studies or research performed on newborns and
infants suffering from SBS, but the majorities are equally relevant
to the adolescent and adult age group.
General
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