Short Bowel Syndrome: Symptoms, Causes, and Treatment
Updated: 49 minutes ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: September 2026
TL;DR
Short bowel syndrome (also called short gut syndrome) is a condition in which the small intestine cannot take in enough nutrients from food. It happens when the intestine is shorter than typical — often after surgery — or absorbs nutrients poorly. The main symptoms are diarrhea, weight loss, extreme tiredness, and dehydration. Treatment usually starts with IV or tube feeding and may include medicines, a special diet, and sometimes surgery.
Quick Answer
What is short bowel syndrome and how is it treated? Short bowel syndrome is a condition in which the small intestine cannot absorb enough nutrients and fluids from food, either because it is shorter than typical or its absorptive ability is decreased. Most cases follow surgery to remove part of the intestine; some babies are born with a shortened or incomplete small intestine. Treatment focuses on supplying nutrition through an IV line (parenteral nutrition) or a feeding tube (enteral nutrition), then gradually introducing a carefully planned diet as the intestine adapts. In adults, this adaptation takes about two years.
What Is Short Bowel Syndrome?
Short bowel syndrome is a condition in which the small intestine cannot take in enough nutrients from foods. This happens because the intestine is shorter than a typical small intestine or because its ability to absorb nutrients is decreased.
One role of the small intestine, also called the small bowel, is to absorb nutrients and fluids from food. The nutrients then circulate through the bloodstream. A short bowel may not be able to absorb enough nutrients for the body's needs.
This condition also is called short gut syndrome. It most often develops after surgery to remove part of the small intestine, but some babies are born with an intestine that is shorter or not fully formed.
Symptoms of Short Bowel Syndrome
The most common symptom is diarrhea, often with greasy, foul-smelling stools. Because the body takes in less nutrition, weight loss and extreme tiredness are also common.
Infants and children may show slower growth and development than expected. Low fluid levels, called dehydration, also frequently occur.
Signs of Dehydration
Sign of Dehydration | What to Watch For |
|---|---|
Urine changes | Dark-colored urine |
Mouth and thirst | Extreme thirst or dry mouth |
Energy | Tiredness, lightheadedness or fainting |
Face | Sunken eyes or cheeks |
Babies | Dry diapers for three or more hours |
Babies | Crying without tears in children |
Symptom Summary
Symptom | What It Looks Like |
|---|---|
Diarrhea | Frequent loose stools |
Stool quality | Greasy, foul-smelling stools |
Energy | Extreme tiredness |
Weight | Weight loss |
Nutrition | Malnutrition (not enough nutrition from foods) |
Children | Slower growth and development than expected |
What Causes Short Bowel Syndrome?
Several conditions of the small intestine are treated by surgery to remove damaged or diseased tissues. A shortened small intestine after surgery may not be able to absorb enough nutrients and fluids. The type and amount of nutrition loss depend on how much of the small intestine was removed and what section was removed.
The conditions that may lead to removal surgery include the following.
Condition | What It Is |
|---|---|
Necrotizing enterocolitis | A condition affecting newborns that causes inflammation and death of intestinal tissues |
Volvulus | Twisting of the small intestine around itself |
Crohn's disease | A long-term condition that damages tissues of the small intestine and affects how it works |
Cancer or radiation | Cancer of the small intestine or radiation treatment for cancer |
Mesenteric ischemia | A condition that cuts off or limits the blood supply to the small intestine |
Traumatic injury | Traumatic injury to the belly |
Conditions Present at Birth
Some conditions present at birth result in an infant not having a fully working small intestine. These include a small intestine that is not as long as is typical at birth, gastroschisis (a condition where part of the small intestine is outside of the skin of the belly), and intestinal atresia (a condition where some part of the small intestine is not completely formed).
Who Is at Risk?
Risk Factor | How It Raises Risk |
|---|---|
Surgery to remove part of the small intestine | Increases the risk of short bowel syndrome |
Premature birth and very low birth weight | Increase the risk of a small intestine that is not fully developed or has a condition that requires surgery to remove part of the bowel |
Complications of Short Bowel Syndrome
A lack of essential vitamins and minerals can cause many complications. These include low amounts of oxygen-rich red blood cells, bone diseases or weak, fragile bones, delayed growth and development of children, and other conditions caused by vitamin deficiencies.
Long-Term Complications
Complication | Description |
|---|---|
Frequent diarrhea | Persistent loose stools |
Dehydration | Low fluid levels from ongoing losses |
Food allergies and intolerance | Seen in children |
Bacterial overgrowth | Overgrowth of bacteria in the small intestine |
Liver disease | A serious long-term complication |
Gallstones | Stone formation in the gallbladder |
Kidney problems | Kidney stones and poor kidney function |
Ulcers | Ulcers of the stomach and esophagus |
Malnutrition | Ongoing inadequate nutrition |
Growth delays | Lack of expected growth and development in infants or children |
Tube-related issues | Complications related to IV lines and feeding tubes used for nutrition |
How Short Bowel Syndrome Is Diagnosed
Your healthcare professional will do a physical exam and ask questions about symptoms, diet, and medical history. This includes a history of any surgery to remove part of the small intestine.
Several tests can help diagnose short bowel syndrome or rule out other causes of symptoms.
Test | What It Measures |
|---|---|
Blood tests (vitamins and minerals) | Levels of vitamins and minerals |
Blood tests (infection/immune) | Signs of infection or irregular immune system activity |
Stool tests | Levels of nutrients in stool and how well nutrients are being absorbed |
Imaging tests | Whether blockages or other conditions are causing the symptoms |
Treatment for Short Bowel Syndrome
Treatment options vary depending on what section of the small intestine was removed or is not functioning well. In general, the treatment goals are to make sure you receive the nutrition your body needs and to manage complications. The hope is for the small intestine to adapt as much as possible and absorb the nutrition you need.
Nutrition Support
Treatment of short bowel syndrome usually involves getting nutrition through a tube placed in a vein or through a feeding tube to the stomach. The condition also may be managed with a special diet and nutritional supplements.
Parenteral nutrition is a method of getting all the nutrients and fluids you need through a tube placed in a vein, called an IV line. This is usually needed at the beginning of treatment.
Enteral nutrition is the use of a feeding tube. This tube may go through the nose or mouth and down the esophagus to the stomach. Other tubes may be surgically placed through the wall of the belly and into either the stomach or small intestine. This may be started while you're still getting some nutrients through an IV.
A carefully planned diet may begin as the small intestine adapts to absorbing nutrients. Eating may be introduced gradually while getting enteral nutrition to ensure that you get enough nutrients.
For adults, it takes about two years for the small intestine to adapt. In children, it takes longer. How far someone progresses with treatment varies. Some people may need a feeding tube for all or some of their nutritional needs. Some people will be able to eat a carefully planned diet to make sure they get enough vitamins, minerals, and fluids.
Medicines
Medicine Type | What It Does | Examples |
|---|---|---|
Antidiarrheals | Slow movement of food and waste through the intestines and treat diarrhea | Loperamide (Imodium), available with or without a prescription; diphenoxylate (Lomotil) |
Proton pump inhibitors (PPIs) | Reduce production of stomach acids; reducing stomach acids may improve small intestine function | Available with or without a prescription; OTC options include lansoprazole (Prevacid 24 HR), omeprazole (Prilosec OTC), and esomeprazole (Nexium 24HR) |
H-2-receptor blockers | Reduce acid production; available with or without a prescription | OTC options include cimetidine (Tagamet HB), famotidine (Pepcid AC), and nizatidine (Axid AR) |
Glucagon-like peptide 2 (GLP-2) | A growth hormone that may improve how well the small intestine absorbs nutrients; may help people move from IV nutrition to a feeding tube | Given with a shot |
Nutritional support | Ensures enough calories, vitamins, minerals, and micronutrients | Taken as supplemental pills, given with shots or IVs, or added to tube feedings |
Surgery
Surgery may be necessary for people who depend on getting nutrition through an IV line.
Procedure | What It Involves |
|---|---|
Intestinal lengthening | A segment of the small intestine is removed and divided in half lengthwise. Each half is then closed lengthwise to create two narrower tubes. These segments are then reattached to the rest of the intestine. |
Serial transverse enteroplasty (STEP) | This procedure remodels a segment of the small intestine to create a zigzag pattern. This slows the movement of food and allows the small intestine to absorb more nutrients. |
Small bowel transplantation | Surgery to transplant a small intestine from an organ donor; usually considered when a person is dependent on IV nutrition and has serious complications such as liver disease. |
Preparing for Your Appointment
If you or your child has had surgery to remove part of the small intestine, an ongoing part of care is watching for complications, including short bowel syndrome. Your healthcare team will likely include a specialist in digestive diseases, called a gastroenterologist; a surgical team; and a nutrition specialist.
For children who have symptoms of short bowel syndrome but have not had surgery, an appointment will likely start with your pediatrician or family healthcare professional.
What You Can Do
Before any appointment with your team, make a list of your symptoms, including any that seem unrelated to the reason for your appointment. Include key personal information such as major stresses, recent life changes, and family medical history.
Bring your detailed medical and surgical history, including details highlighting how much of the small intestine was removed. List all medicines, vitamins, or other supplements you or your child take, along with doses and reasons for taking each one.
If possible, bring a friend or family member who can take notes during appointments. If you get a diagnosis of short bowel syndrome, ask if there are any brochures or websites that provide useful information.
Questions Your Healthcare Professional May Ask
Questions for Adults | Questions for Children |
|---|---|
When did symptoms begin? | When was your child's most recent wellness visit? |
Do the symptoms come and go, or are they constant? | Is your child being breastfed or drinking formula? |
Have you experienced unexpected weight loss? | Is your child eating solid foods? |
What foods do you typically eat? | How often does your baby have a wet diaper? |
Have you been diagnosed with any conditions of the digestive tract? | Does your child cry without tears? |
If so, what treatments have you had? | Does your child seem unusually irritable? |
What surgeries on your gut have you had? | Has your child been diagnosed with any long-term disease? What bowel surgeries has your child had? |
Conclusion
Short bowel syndrome is a serious but manageable condition in which the small intestine cannot absorb enough nutrients and fluids. Most cases follow surgery to remove part of the intestine, and treatment begins with IV or tube feeding while the bowel adapts — a process that takes about two years in adults. With the right nutrition plan, medicines, and specialist care team, many people eventually move toward eating a carefully planned diet.
Take the next step: If you or your child has diarrhea, weight loss, dehydration signs, or slower-than-expected growth after intestinal surgery, schedule an appointment with a healthcare professional.
Frequently Asked Questions
What is short bowel syndrome?
Short bowel syndrome, also called short gut syndrome, is a condition in which the small intestine cannot take in enough nutrients from foods. This happens because the intestine is shorter than typical or because its ability to absorb nutrients is decreased.
What causes short bowel syndrome?
The most common cause is surgery to remove part of the small intestine to treat another condition, such as Crohn's disease, cancer, volvulus, necrotizing enterocolitis, or mesenteric ischemia. Some babies are born with a small intestine that is shorter than typical, incomplete (intestinal atresia), or outside the belly wall (gastroschisis).
What are the main symptoms?
The main symptoms are diarrhea, greasy foul-smelling stools, extreme tiredness, weight loss, and malnutrition. Infants and children may show slower growth and development. Dehydration is common, with signs such as dark-colored urine, dry mouth, and sunken eyes.
How is short bowel syndrome treated?
Treatment usually starts with parenteral nutrition — getting all nutrients and fluids through an IV line. A feeding tube (enteral nutrition) may be added, and a carefully planned diet is introduced gradually as the intestine adapts. Medicines, supplements, and sometimes surgery are also used.
How long does it take for the intestine to adapt?
For adults, it takes about two years for the small intestine to adapt. In children, it takes longer. How far someone progresses varies — some people need a feeding tube long term, while others can meet their nutritional needs with a carefully planned diet.
What medicines are used for short bowel syndrome?
Medicines include antidiarrheals such as loperamide (Imodium) and Lomotil, acid reducers such as PPIs (omeprazole, lansoprazole, esomeprazole) and H-2-receptor blockers (famotidine, cimetidine, nizatidine), GLP-2 hormone given by shot to improve absorption, and nutritional support through pills, shots, IVs, or tube feedings.
Is surgery ever needed?
Yes. Procedures include intestinal lengthening, the serial transverse enteroplasty (STEP) procedure that remodels a bowel segment into a zigzag pattern, and small bowel transplantation from an organ donor. Transplant is usually considered for people who depend on IV nutrition and have serious complications such as liver disease.
What complications can occur?
Complications include dehydration, malnutrition, liver disease, gallstones, kidney stones, bacterial overgrowth in the intestine, ulcers, weak bones, low red blood cells, and delays in children's growth and development. People on IV lines and feeding tubes can also have tube-related complications.
Related Resources
External resources from authoritative health organizations:
Disclaimer: This article is for general informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
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