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

Many patients with SBS have had a substantial 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 fluids⁶

Many patients with SBS require long-term PS to maintain nutrition, 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% were Caucasian, 16% Black, and 6% other

Majority were female (66%)

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

Surgical complications 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
intestine leads to loss of:

Absorptive surface area⁶

Loss of absorptive surface area, causing malabsorption of nutrients, electrolytes and water.

Insufficient intestinal absorptive function^6,9

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

Endocrine cells and GI peptides⁶

Peptide deficiency (ie, GLP-1 and GLP-2) 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

Targeted therapy

GLP-2 analogs

Surgical¹⁴

Intestinal lengthening procedures
Intestinal tapering
Intestinal transplantation

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

According to a survey, patients with SBS
spend significant time receiving PS⁴

12.4

hours per day (range: 9-18 hours)

days per week (range: 3-7 days)

You could walk across the Golden Gate
Bridge and back 18½ times in the time it takes the average patient with SBS to receive their PS every day.⁴

You could cover the length of a football field with the 312 PS bags used by the average patient with SBS in one year¹⁶

Patients with SBS dependent on PS may experience¹⁷:

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.¹⁷

Although life-saving, PS can lead to life-threatening complications such as catheter-related bloodstream infections, venous thrombosis, metabolic bone disease, and liver disease.^15,17

Sleep disturbances are
Commonly reported by
patients with SBS who are receiving PS⁴

According to a survey, 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
disease¹⁸

26%of patients

develop liver disease after 2 years of PS

PS is supportive management and therefore does not treat insufficient absorptive capacity, which is the underlying issue for patients with SBS who are dependent on PS.³

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 lives¹⁰

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

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

Surgical complications are the leading causes of SBS in adults8

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

SURGICAL RESECTION of the 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