Short Bowel Syndrome in Children
If a child’s intestine has been partially removed due to medical necessity, they have a condition known as short bowel syndrome (SBS). This condition can cause malnutrition and poor growth because the small intestine in not able to fully absorb the food and nutrients that help the body function.
The SLUCare Physician Group specialists at SSM Health Cardinal Glennon Children’s Hospital are leaders in the care of children with this condition.
Our team takes a multi-disciplinary approach to caring with children with short bowel syndrome. Through Glennon Intestinal Rehabilitation and Feeding (Short Bowel Syndrome), or GIRAF, our nutrition and intestine specialists, surgeons and dietitians care for infants and children who cannot feed by mouth as a result of premature birth, illness or injury. We use a wide array of technologies to keep children healthy and growing even when oral feeds are insufficient. The goal of GIRAF is to maintain good health, promote normal growth and support the family while the child recovers and advances to normal eating.
Signs & Symptoms of Short Bowel Syndrome
Depending on how well the small intestine is working, short bowel syndrome may be associated with mild to severe symptoms. Children suffering from SBS are unable to absorb enough water, vitamins, minerals, protein, fat, calories and other nutrients from food that they consume. This results in a host of symptoms including:
- Excessive gas or foul-smelling stool, or both
- Poor appetite
- Weight loss or inability to gain weight
Other complications that can occur as a result of short bowel syndrome include:
- Vitamin, mineral and electrolyte imbalance
- Severe diaper rash (due to frequent diarrhea)
- Abnormal eating habits
- Kidney stones or gallstones
- High levels of bacteria in the intestine
Short bowel syndrome typically occurs in children who have significant damage to the small intestine due to necrotizing enterocolitis, or inflammation and a loss of blood flow to the intestine. Other causes of SBS are:
- Congenital defect: small intestine does not completely form
- Crohn's disease: children who have undergone surgery for this condition are more prone to SBS
- Intussusception: blood flow to the intestine is compromised due to abnormal folding
- Injury to the intestine: due to twisting of the intestine, trauma, tumor or abnormal blood flow (ischemia)
Diagnosing Short Bowel Syndrome
To confirm an SBS diagnosis, our doctors will perform:
- Medical and family history
- Physical exam
- Blood tests
- Fecal fat tests
- An X-ray of the small and large intestines
- Upper gastrointestinal (GI) series
- Computerized tomography (CT) scan
Treating Short Bowel Syndrome
Children with SBS must bypass the small intestine to properly receive nutrition. Doing this requires the use of a catheter or feeding tube. Depending on your child’s situation, our doctors might recommend any of the following treatments:
- Parenteral nutrition (TPN): a mixture of fluids and nutrients given intravenously (by an IV)
- Enteral feeding: a child receives food through a gastric tube (g-tube), a nasogastric (NG) tube or (jejunostomy tube or j-tube); can replace TPN in some patients
- Surgery: procedures such as Bianchi procedure and serial transverse enteroplasty procedure (STEP) can improve the functional length of the intestine
- Intestinal adaptation: after surgery the intestine may grow in size, and become thicker, helping to properly absorb nutrients
- Intestinal transplant: recommended when other treatment options fail or when long-term TPN causes life-threatening complications
- Medications: helps to slow food digestion, allowing additional time for the nutrients to remain in contact with the intestine and improve absorption
Some children may be able to receive small amounts of solid food and liquids in addition to enteral or parenteral (intravenous) feeding. This helps in the development of normal eating patterns in the future.
If your child has been diagnosed with short bowel syndrome, we will help you navigate this journey, tailoring all of our services to your child’s unique needs. To schedule an appointment with our team, please call our team at 314-268-4010. We’ll work you on the road to helping your child heal.