SHORT BOWEL SYNDROME: NURSING ASSESSMENT, CLINICAL MANAGEMENT, AND EVIDENCE-BASED CARE-AN UPDATED REVIEW

Nader Saad Awad Al-Mutairi*, Mashan Mashal Hubaylis Alharthi, Shaie Saleh, Hzam Alkorbi Zid Aldossri, Mohammad Naseer Ali Alqahtani, Faisal Zabin Hashar Alotaibi

ABSTRACT

Background: Short bowel syndrome (SBS) is a complex gastrointestinal disorder resulting from extensive loss of functional small intestine, leading to intestinal failure, malabsorption, fluid imbalance, electrolyte disturbances, and chronic nutritional deficiencies. Despite advances in intestinal rehabilitation and parenteral nutrition (PN), SBS continues to present significant clinical challenges that require comprehensive multidisciplinary management. Nurses play a pivotal role in early assessment, nutritional monitoring, prevention of complications, patient education, and coordination of long-term care. Aim: This review aimed to provide an updated evidence-based overview of short bowel syndrome, emphasizing its epidemiology, pathophysiology, intestinal adaptation, nutritional management, nursing assessment, pharmacological therapies, and multidisciplinary interventions that improve clinical outcomes and quality of life. Methods: A comprehensive narrative review of current scientific literature was conducted using published clinical guidelines, systematic reviews, observational studies, and landmark clinical trials addressing the diagnosis, management, and rehabilitation of patients with SBS. The review integrates contemporary evidence regarding intestinal physiology, parenteral nutrition, emerging pharmacological therapies, and nursing care strategies. Results: The evidence demonstrates that successful management of SBS depends on individualized multidisciplinary care focused on maintaining hydration, correcting nutritional deficiencies, promoting intestinal adaptation, minimizing dependence on long-term PN, and preventing treatment-related complications. Early nutritional intervention, optimized enteral feeding, meticulous catheter management, pharmacological therapies including antidiarrheal agents and glucagon-like peptide-2 analogues such as teduglutide, and structured intestinal rehabilitation programs significantly improve intestinal function and patient outcomes. Conclusion: Short bowel syndrome remains a lifelong condition requiring individualized, evidence-based management delivered through coordinated multidisciplinary care. Nurses are central to optimizing nutritional status, preventing complications, supporting intestinal rehabilitation, promoting patient self-management, and improving long-term survival and quality of life.

Keywords: Short bowel syndrome; Intestinal failure; Parenteral nutrition; Home parenteral nutrition; Intestinal adaptation.