Short bowel syndrome-associated intestinal failure: diagnosis and prognosis.

Abstract

Introduction: Short bowel syndrome is characterized by severe intestinal malabsorption of macronutrients, micronutrients, fluid, and electrolytes. As such, short bowel syndrome often results in permanent need of parenteral support, that is, intestinal failure. To optimize patient outcomes, it is important to establish precise definitions of short bowel syndrome and intestinal failure. Classifying those with SBS can provide useful prognostic, risk and therapeutic implications.

Areas covered: This narrative review will focus on the diagnosis and prognosis of this rare condition. A literature search was performed utilizing PubMed and reviewed references from applicable manuscripts primarily between 2000 and September 2025.

Expert opinion: Short bowel syndrome in adults is a clinical malabsorptive syndrome associated with having <200 cm of residual small bowel in continuity, measured from the duodenojejunal flexure. Intestinal failure is the reduction of gut function below the minimum required for the absorption of macronutrients and/or water and electrolytes, thereby requiring parenteral support to maintain health and/or growth. The remaining small bowel length and segment, and health of the remnant bowel have important prognostic implications. Care gaps exist regarding the diagnosis and management of this condition and future efforts should address these disparities in order to provide optimal care to these patients.