Pediatric short bowel syndrome (SBS)

What is pediatric short bowel syndrome (SBS)?

pediatric short bowel syndrome (SBS) means that a large part of a child's small intestine is missing or doesn’t work the way it should. SBS can occur in newborns or older children. Sometimes it results from a condition that is present at birth (congenital). In other cases, it can happen after doctors surgically remove a large part of the small intestine because of an infection, injury or chronic condition.

The small intestine is essential for absorbing water and nutrients from the food we eat. Children with SBS don’t have enough healthy small intestine to stay hydrated and absorb the nutrients they need to grow and thrive. This condition requires treatment and follow-up care throughout childhood.

What are the signs and symptoms of pediatric short bowel syndrome (SBS)?

• Abdominal pain

• Abnormal weight loss

• Dehydration

• Diarrhea

• Fatigue (feeling tired)

• Foul-smelling stool

• Lack of enough nutrition or malnutrition

• Poor growth (failure to thrive)

• Too much gas

• Vomiting

What are the complications for children with short bowel syndrome (SBS)?

• Liver disease

• Kidney and ureteral stones (nephrolithiasis)

• Small intestinal bacterial overgrowth

How is pediatric short bowel syndrome (SBS) diagnosed?

Your child may need one or more tests to make a diagnosis, including:

• Blood tests to determine nutrient levels absorbed in the bloodstream

• Imaging, such as X-ray, CT scan and ultrasound, to determine the length of the small intestine

• Stool tests to help assess how well the small intestine works

• Endoscopy, a procedure that enables doctors to view inside the upper digestive system, including the stomach and small intestine, and sometimes take tissue samples for testing

• Colonoscopy, a procedure that enables doctors to view inside the lower digestive system, including the colon and rectum, and sometimes take tissue samples for testing

• Upper GI series with small bowel follow through, a fluoroscopy procedure that enables doctors to observe the size, shape and function of the esophagus, stomach and small intestine

What causes pediatric short bowel syndrome (SBS)?

In newborns:

• Gastroschisis

• Intestinal atresia

• Necrotizing enterocolitis

In older children:

• Crohn’s disease

• Intestinal injury from trauma

• Intussusception

• Midgut volvulus

How is pediatric short bowel syndrome (SBS) treated?

SBS treatment varies based on which parts of your child’s small intestine is missing and how much works properly. At Children’s Health, we’re national experts in treating all children with SBS, even the most complex cases.

Our team works together to determine the best treatment plan for your child’s unique condition, which can include:

Nutritional management

Your child will need to follow a special diet to ensure they receive enough nutrients. Some children may also need:

• Total parenteral nutrition (TPN) - This means that your child receives nutrients directly into a vein. It’s often used as a short-term treatment after surgery.

• Enteral nutrition - Also known as tube feeding, means your child receives nutrients through a tube that goes to their stomach. The nutrition may go through a nasogastric (NG) tube, which doctors insert in the nose and guide down the throat to the stomach. Doctors may use a gastrostomy tube (G-tube) inserted directly into the stomach during a small surgical procedure. Enteral nutrition often replaces TPN.

• Feeding therapy - With a therapist help, you can help your child overcome any challenges they may have with swallowing foods and liquids.

Medications

Some children need medication to treat diarrhea and help them absorb water and nutrients. Doctors may also prescribe medication to help control stomach acid and prevent peptic ulcers, a common complication of SBS.

Surgery

Doctors may recommend surgery that can improve the function of the small intestine. Our pediatric gastroenterologists and surgeons are national leaders in the latest techniques that help children who undergo these procedures have the best possible outcomes.