Improving Identification of Short Bowel Syndrome to Optimize Nutrition and Hydration Status


Short bowel syndrome (SBS) is an extreme malabsorptive disorder associated with malnutrition, dehydration, and many co-morbidities. Because SBS is so rare and complex, the RDN may find themselves taking care of such a patient without the experience or tools to do so. This can lead to poor care for patients. An intestinal rehabilitation unit in the UK published an article titled “Mistakes in short bowel and how to avoid them” due to the sheer number of times these errors were experienced by patients referred to their specialized unit. The terms SBS and intestinal failure (IF) are frequently used interchangeably, however important distinctions exist between them. IF is the reduction in gut function below the minimum necessary for the absorption of macronutrients, water, and electrolytes such that parenteral nutrition (PN)/IV supplementation is required to maintain health. SBS then, includes all those who do not require PN, but SBS they have nonetheless. A common assumption is that if a patient with SBS does not require PN/IV fluids, their SBS is not that serious. The goal of this session is to equip the RDN to play an integral role in the identification of the patient with SBS, and to intervene appropriately with diet, hydration, and medication recommendations.

Learning Objectives

Describe the factors contributing to diarrhea and malabsorption in short bowel syndrome

Optimize nutrition and hydration in the patient with SBS and protect patients from dehydration and renal injury

Select and dose medications in a stepwise fashion to maximize absorption, improve quality of life and achieve enteral autonomy where possible

Performance Indicators

10.2 Conducts a nutrition assessment to establish nutrition diagnoses, prescriptions, and care plans

10.3 Establishes and implements evidence-based nutrition interventions to address PES statements and client/patient goals

10.4 Prescribes, recommends and administers nutrition-related pharmacotherapy to support optimal patient/client outcomes according to standard of practice, legislation and organizational policies


Maria Karimbakas

Optum Intestinal Rehab (OIR) Program Manager

Optum Infusion Pharmacy

Elizabeth Wall

Advanced Clinical Specialist, GI/Nutrition Support

The University of Chicago Medicine


Carol Rees Parrish

GI Nutrition Support Specialist

Self-employed now

Scroll to Top