Nutrition Services for adults

Short Bowel Syndrome advice

The webpage provides information and advice for patients who may have a condition called short bowel syndrome. This is when either you have had surgery to remove part of your bowel (see diagram below) or it may not be working as it should and therefore cannot absorb enough fluid to keep you properly hydrated.

When large amounts of small bowel have been removed or the small bowel is not working normally, you may not be able to maintain your hydration by drinking fluids alone. You may need to have fluids given via a vein, this is called intravenous fluid. High losses/output from the bowel or stoma increases the risk of dehydration due to water and salt losses. High output is anything more than 1,500ml/day.

You may also need to have nutrients and calories given via a vein if you can't absorb enough nutrients from your bowel and you are losing weight. This is called parenteral nutrition. Your fluid and diet will be discussed with you and a guide noted in your personal plan.

                                                Gastrointestinal system image


FluidsShow [+]Hide [-]

Drink 1,000ml (volume may be more) of a glucose/salt solution per day eg Dioralyte (eight sachets in 1,000ml) or St. Marks oral rehydration solution (see recipe below):

  • Restrict other fluids to around 1,000ml/day (see list below*)
  • Drink between meals instead of with meals

Note: Check with your clinical team as to the correct volumes of fluid you need. On hot days or if fluid losses increase then you may need to increase the volume.

: Check with your clinical team as to the correct volumes of fluid you need. On hot days or if fluid losses increase then you may need to increase the volume.

Recipe for St. Marks Solution

  • 20g/six level 5ml spoonfuls glucose
  • 3.5g/one level 5ml spoonful salt
  • 2.5g/one heaped 2.5ml spoonful sodium bicarbonate
  • Dissolve in 1,000ml water.
  • Keep chilled in the fridge.
  • Flavour with a small amount of squash or cordial.

(You can get a 2.5ml/5ml measuring spoon from your pharmacist).

*From this list, do not drink in total more than 1000ml each day

  • Sugary drinks e.g. lemonade, cola, high energy drinks
  • Pure fruit juice
  • Milk
  • Tea
  • Coffee
  • Water
  • Diet drinks

DietShow [+]Hide [-]

You will be asked to follow a low fibre diet, this helps to reduce stoma losses.

Avoid the following foods

  • Fruit (including dried)
  • Salad Peeled fruits
  • Nuts
  • Sweetcorn
  • Tinned fruit in juice
  • Pips
  • Mushrooms
  • Stewed or baked fruit
  • Pith Peas
  • 150ml fruit juice
  • Seeds
  • Onions
  • Well cooked vegetables
  • Raw vegetables
  • Chilli
  • Vegetable skins

You may be able to try the following fibrous foods after discussion with your dietitian:

  • Peeled fruits
  • Tinned fruit in juice
  • Stewed or baked fruit 150ml fruit juice
  • Well cooked vegetables

Choose low fibre starchy carbohydrates

  • White bread, rolls, chapattis, naan breads
  • Rice based cereals, corn flakes, frosted flakes, coco crispies
  • Potatoes without skins
  • White pasta, rice, semolina, tapioca
  • Dishes which contain maize, millet or cornmeal
  • These foods will help thicken your stoma output and give you energy.
White bread, rolls, chapattis, naan breads

Include some protein in your diet:

  • Meat, fish, eggs, cheese
Meat, fish, eggs, cheese

Check with your dietitian which protein foods are suitable for you.

It is important you discuss the above with your nutrition team/dietitian to make sure you have a balanced diet.

MedicationShow [+]Hide [-]

The following medications are prescribed to help to reduce stoma output:

  • Loperamide – take this at least 30 minutes before food
  • Codeine phosphate
  • Lansoprazole/omeprazole
  • You may need additional medications or supplements including:
  • Magnesium
  • Calcium/Vitamin D
  • Iron
  • Vitamin B12 injections (hydroxocobalamin)
  • Multivitamin.

Your pharmacist/clinical team will advise on the dose and frequency of these medications.

For further informationShow [+]Hide [-]

Contact details

The Patient Advice and Liaison Service (PALS) can offer on-the-spot advice and information about the NHS.

Useful websites

If you would like further information about health conditions and treatment options, you may wish to have a look at the NHS Choices website. On this website there is an information prescription generator which brings together a wealth of approved patient information from the NHS and charity partners which you may find helpful.

Leaflet to download

You can download the information on this page as a PDF leaflet.pdf 

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