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  • Q&A with Australian Health Practitioners

    What is the relationship between Crohn’s disease and short bowel syndrome?

    I was recently diagnosed with Crohn’s disease and am scheduled to have surgery next month. I have heard that the surgery may result in side effects including “short bowel syndrome”. What is this condition and how will it affect me?
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    Dr Andrew Sutherland

    Colorectal Surgeon (Bowel)

    I am a specialist colorectal surgeon treating a range of bowel diseases and am committed to providing the best of care for all patients. It … View Profile

    Short bowel syndrome essentially refers to the situation where there is not adequate bowel remaining and functioning effectively to perform all of its vital functions.  This refers to the small bowel as the large bowel, or colon, does not peform vital functions even if they are important.

    Specialist colorectal surgeons who manage Crohn's disease are well aware of the potential for short bowel syndrome.  This is not only an immediate possibility but also one for the future if further surgery is ever required.  As a result every effort is made to preserve as much bowel as possible and remove only the most diseased segments that are causing complications.

    The risk of developing short bowel syndrome after a single operation for Crohn's disease is very small with our current understanding of the disease, surgical techniques and medical therapy.

    The small bowel digests food and then absorbs nutrients and fluid.  Without an adequate length of functioning small bowel you can become malnourished and dehydrated.  There is no special length of bowel that works for everyone and if you have that much you will be ok.  Also not all nutrients are absorbed in the same part of bowel or need as much bowel to be absorbed.  As such people can develop specific nutritional deficiencies after relatively short lengths of bowel have been removed (B12 and terminal ileum/end of ileum is best exampe).  For relatively simple situations like this it may be just a matter of taking a dietary supplement or having regular B12 injections.  

    As increasing lengths of bowel are removed, or stop functioning effectively due to disease, the range and severity of nutritional deficincies is likely to increase.  This can lead to weight loss, anaemia, liver disease, severe dehydration and may  make people reliant on special highly restricted diets or eventually on feeding directly into the blood stream (TPN/ Total Parenteral Nutrition).

    If you are concerned about the potential for short bowel syndrome then it is something that you need to discuss with your surgeon well before your operation so that the actual risk can be explained to you.

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