Short bowel syndrome

Intestinal failure can occur when a large portion of the small intestine has been surgically removed resulting in short bowel syndrome, a newborn has an abnormal intestine, or in cases of intrinsic bowel disease, such as Crohn's disease or motility disorder. Diarrhea is inevitable for patients who have had extensive small intestinal resection and have developed short bowel syndrome. Almost all patients with short bowel syndrome at one time or another need parenteral nutrition, or intravenous fluid and electrolyte therapy. Although the need for parenteral nutrition and electrolyte therapy may be transient, intermittent, or chronic, it is often life-sustaining therapy. This chapter provides examples of total parenteral nutrition order forms, component composition, and suggested monitoring blood work and additive routines for the adult population. Intestinal transplantation has become a life-saving treatment that can be considered for patients with irreversible intestinal failure who cannot be maintained on parenteral nutrition.