Small bowel syndrome, more commonly known as short bowel or short gut syndrome, is a condition where a large resection of the small intestine results in decreased digestion and absorption of nutrients from food and water. Definitions vary as to the different lengths of intestine that classify as small bowel syndrome. The American Gastroenterological Association states that small bowel syndrome is when a postsurgery patient is left with less than 200 cm of functional small bowel.
Importance of Diet
After surgical treatment for a certain disease or trauma to the small intestine or colon, your body must heal and regain normal bowel function. Initially your physician or surgeon will provide your nutrients intravenously, which is called total parenteral nutrition. In the next two to six weeks, you will advance to clear liquids and eventually add foods easier on the digestive system, such as low-fat and lactose-free foods and beverages. In addition to healing, your body must adapt to the reduced surface area of your intestines and colon, which cause malabsorption and maldigestion of nutrients initially. Upon discharge from the hospital, you will most likely receive parenteral nutrition or enteral tube feedings in addition to your limited oral diet until you can consume enough calories by oral nutrition alone.
Diet Guidelines
Basic guidelines for short bowel syndrome diet are to eat small, frequent meals to ease the workload of your digestive system. Chew your foods well, and limit the amount of fluids you consume with your meals or separate the time between eating liquids and solids. Preferably eat solids before liquids, because solids slow the emptying of your stomach and liquids will help pass the food through your digestive system. Avoid concentrated sweets and fluids to prevent diarrhea, and restrict lactose if necessary.
Grains
Many grain products are still acceptable when you have small bowel syndrome. However, avoid donuts, pastries, sugary cereals, high-fiber cereals and flavored oatmeal. Good grain choices are breads, pitas, rolls, whole-wheat flour or corn tortillas that are toasted, pasta, brown rice, white rice and wild rice. Acceptable breakfast foods are unsweetened cereal, cornflakes, rice puffs, cream of wheat, grits and unflavored oatmeal. Plain waffles or pancakes, corn bread, plain muffins and banana bread are also acceptable grain choices.
Fruits and Vegetables
Fruits lower in fiber such as bananas, melons, unsweetened canned applesauce, pears, peaches, cherries, plums and mandarin oranges are good choices. Avoid high-fiber or high-sugar choices such as dried fruits, canned fruit in syrup, fruit drinks and drinks with high fructose corn syrup. Canned or cooked vegetables, potatoes, sweet potatoes, yams and small amounts of lettuce are easier for the digestive system to handle than creamed vegetables and legumes such as kidney, pinto or lima beans.
Meat, Eggs and Dairy
Meat, fish, shellfish, poultry, tuna and ham are fine unless they are heavily fried. Cheese, plain yogurt or yogurt sweetened with artificial sweeteners and plain soy milk are acceptable. Avoid cream, half-and-half, flavored milk and highly sweetened yogurt. Scrambled, poached, hard-boiled eggs and omelets are allowed if they are eaten by themselves with no other ingredients.
Beverages, Snacks and Desserts
Beverages are extremely limited in this diet to avoid overwhelming the digestive system. Acceptable beverages are oral rehydration solutions, lactaid milk, less 4 oz. of soups and broth per day. Avoid consuming more than 4 oz. of coffee, tea, hot cocoa, fruit juices, soda, alcohol, water or sugar-free beverages. Acceptable snacks are salty foods such as crackers, pretzels, corn chips and potato chips. Desserts are limited to angel food cake, vanilla wafers, shortbread, plain pound cake, cake donuts, peanut butter, animal crackers and graham crackers.
References
- Memorial Sloan-Kettering Cancer Center: Short Bowel Syndrome
- "Nutrition Therapy and Pathophysiology"; Marcia Nelms; 2007.
- National Institutes of Health: Short Bowel Syndrome
