Patients with SHORT BOWEL SYNDROME
SYNDROME suffer from
irreparable GI damage and
functional deficiency of
the intestines^1,4

Patients with SBS have had a large section of their small intestine removed. In some patients, the colon or large intestine may also be removed^1,3,5

Patients experience impaired intestinal absorption of macronutrients, micronutrients, electrolytes, and water⁶

Many require long-term PS to maintain energy, hydration, clinical status, and survival^1,5

As of 2021, there are ~12,000 patients in
the United States with SBS who are dependent on PS⁷

77% are Caucasian, 16% Black, and 6% other

Majority are female (66%)

70% of patients are adults 18-64 years of age, and patients 3-17 years of age make up the other 30%

Surgical complications and bowel infarctions are the leading
causes of SBS in adults⁸

Main causes of SBS in adults

% Surgical complications

% Mesenteric infarctions

% Crohn’s disease

% Neoplasms

% Radiation enteritis

% Abdominal trauma

Remnant bowel anatomy is an important clinical factor
for patients with SBS⁵

Patients with SBS can be categorized into 3 groups based on remnant anatomy^5,8:

Type 1
End-jejunostomy

Complete resection of ileum and colon. The jejunum is preserved.

Type 2
Jejuno-colonic anastomosis

Resection of most of the ileum. A portion of the colon is preserved.

Type 3
Jejuno-ileal anastomosis

Retains colon and ileocecal valve with a portion of terminal ileum and jejunum.

SURGICAL RESECTION of the small
intestine leads to loss of:

Absorptive surface area⁶

Important intestinal villi and surface area are diminished, causing malabsorption of nutrients, electrolytes, and water.

Site-specific transport processes^6,9

Intestine fails to absorb amino acids and small peptides, which are resources for protein synthesis and energy.

Endocrine cells and GI hormones⁶

Hormone deficiency (ie, GLP-1, GLP-2, neurotensin, and peptide YY) leads to rapid gastric emptying, shortened intestinal transit, and hypergastrinemia.

Ileocecal valve^3,6,8

Dysregulation leads to bacterial overgrowth, malabsorption of fat and vitamin B12, bile salt deconjugation, fluid loss, and liver injury.

Symptoms of SBS are an everyday concern
for patients³

According to an independent analysis, 50% of patients reported
they have an accident or leak at least once per week.¹⁰

Frequency of accidents or leaks reported by patients with SBS¹⁰:

PIE CHART HERE

Signs, symptoms, and potential complications of SBS include^3,11:

Malnutrition
Weight loss
Drowsiness
Apathy
Low body temperature
Diarrhea
Confusion
D-lactic acidosis

Weakness
Depression
Impaired growth and sexual development
Dehydration
Difficulty concentrating
Irritability
Premature aging

Diarrhea is the most debilitating symptom of SBS for many patients¹²

Nutritional, pharmacologic, and surgical
interventions have different roles in managing SBS^5,12

Nutritional^5,12

PS provides the essential nutrients and fluids
Diet modification includes specialized dietary guidance aimed at improving absorption of oral calories and liquid

Pharmacologic^8,12,13

Symptomatic management

Antidiarrheals
Antisecretory agents (H2 blockers, PPIs)
Bile acid binders
Antibiotics
Pancreatic enzyme replacement therapy
Lactase

Target therapy

GLP-2 analogs

Surgical¹⁴

Intestinal lengthening procedures
Intestinal tapering
Intestinal transplantation

Some patients with SBS require LONG-TERM PS to receive
fluid and nutrients necessary for their survival¹⁵

According to an independent analysis, patients with SBS
spend significant time receiving PS⁴

12.4

hours per day (range: 9-18 hours)

days per week (range: 3-7 days)

Complications of at-home PS dependency for patients with SBS include¹⁶:

Catheter-related infections
IFALD
Metabolic bone disease
Thrombosis

Impaired sleep
Fatigue
Depression
Body image issues

Disrupted social activities*
Strain on relationships with family, friends, partners*

*As reported by family.¹⁶

Although lifesaving, PS can lead to life-threatening complications related to the central venous catheter, liver disease, dehydration, and renal failure.¹⁵

Sleep disturbances are
Commonly reported by
patients receiving PS⁴

According to an independent analysis, 2 OUT OF 3 PATIENTS WITH SBS WHO ARE DEPENDENT ON PS

report disturbed sleep as a result of their treatment

The prolonged use of
PS can lead to liver
disease¹⁷

26%of patients

develop liver disease after 2 years of PS

PS is supportive management and therefore does not treat insufficient absorptive capacity, the underlying issue for patients with SBS who are dependent on PS³

SBS management
goals include¹²:

Decreasing the severity of SBS symptoms
Minimizing complications associated with SBS
Reducing long-term PS dependency

Learn how SBS can affect patients’ daily lives

GI=gastrointestinal; GLP=glucagon-like peptide; IFALD=intestinal failure-associated liver disease; PPI=protein pump inhibitor; PS=parenteral support; SBS=short bowel syndrome.

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As of 2021, there are ~12,000 patients in the United States with SBS who are dependent on PS7

Surgical complications and bowel infarctions are the leading causes of SBS in adults8

Remnant bowel anatomy is an important clinical factor for patients with SBS5

SURGICAL RESECTION of the small intestine leads to loss of:

Symptoms of SBS are an everyday concern for patients3

Frequency of accidents or leaks reported by patients with SBS10:

Signs, symptoms, and potential complications of SBS include3,11:

Nutritional, pharmacologic, and surgical interventions have different roles in managing SBS5,12

Nutritional5,12

Pharmacologic8,12,13

Symptomatic management

Target therapy

Surgical14

Some patients with SBS require LONG-TERM PS to receive fluid and nutrients necessary for their survival15

Complications of at-home PS dependency for patients with SBS include16:

Although lifesaving, PS can lead to life-threatening complications related to the central venous catheter, liver disease, dehydration, and renal failure.15

Sleep disturbances are Commonly reported by patients receiving PS4

The prolonged use of PS can lead to liver disease17

SBS management goals include12:

REFERENCES —

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