A small bowel resection is a surgery in which a portion of the small bowel is removed. The surgery can be performed either laparoscopically or open. Laparoscopic surgery uses a camera inserted into the abdomen through small incisions. The procedure is typically indicated in patients who have obstructions, inflammation, trauma, cancer, precancerous polyps or benign tumors. The surgery decreases the length of the small bowel, resulting in decreased absorption of certain nutrients.
Absorption of Nutrients
The small bowel is made up of the duodenum, jejunum and ileum. The duodenum primarily absorbs carbohydrates and proteins. The jejunum absorbs carbohydrates and proteins. The ileum is responsible for absorbing fats, fat-soluble vitamins and vitamin B12. Most fluid is absorbed in the ileum or in the large intestine.
Short Bowel Syndrome
Short bowel syndrome is a condition of malabsorption of nutrients due to intestinal disease or from surgical removal of part of the small intestine. According to the Mayo Clinic, symptoms include dehydration, greasy and watery diarrhea, foul-smelling stools, weight loss, malnutrition and fatigue. Patients may require lab studies to be performed on blood and stool specimens in order to help make the diagnosis.
General Tips
Patients should learn what types of foods can be tolerated and gradually add in new foods, according to MedlinePlus. Foods should be avoided that cause excessive gas, constipation or loose stools. Meals should generally be spaced out into five to eight small meals instead of three larger meals. These meals should be higher in protein. There is no one specific diet to follow for patients after a small bowel resection.
Supplementation
Patients can receive supplementation in a variety of ways, including orally or intravenously. Some patients require tube feedings or oral supplements to ensure adequate nutrition. Intravenous supplementation, or TPN, is a method of nutrition in which patients receive calories and nutrients through intravenous catheters. Generally it's preferred for patients to achieve as much nutrition as possible through the gut, but some patients don't have adequate length of the gut or function to be able to maintain an appropriate nutritional status.
Hydration
Typically, patients have trouble with loose stools due to the inability of the gut to absorb liquid. The absorption of liquids in the gut is dependent upon the length of the gut remaining. Patients must consume more water each day to avoid becoming dehydrated. Dehydration is a common cause of hospitalization in patients after small bowel resection.
