Short bowel syndrome: How to eat?

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People with short bowel syndrome need to pay close attention to a reasonable diet to improve symptoms as well as quickly restore intestinal health. So, when you have short bowel syndrome, how should you eat?

1. Overview of the structure and function of the intestine

In the human body, the intestine is an organ that includes the small intestine and large intestine (colon), which plays an extremely important role in digesting food and helping the body absorb nutrients from food as well. as the liquid that you consume. The small intestine is responsible for absorbing proteins, carbohydrates, fats, vitamins and minerals. It is about 15 – 20 feet (4.5 – 6 m) long and is divided into 3 parts. The first part is the duodenum, followed by the jejunum, and the last part is the ileum. Each part plays a certain role in the body's digestion and absorption of nutrients. The large intestine is responsible for absorbing water and minerals. In the human body, the large intestine is about 5 feet long, equivalent to about 1.5 m. Another nutrient that plays an equally important role in the digestive tract is fiber. It not only regulates bowel movements, aids in nutrient absorption, but is also a source of raw materials for nourishing beneficial microorganisms in the intestinal tract.
When a part of the body's intestines is removed, the remaining intestines will try to adapt gradually by structural changes to ensure normal digestion. However, it takes a certain amount of time for the rest of the intestines to adapt. If you have recently had surgery, it may be difficult for your body to absorb nutrients, vitamins, minerals, and fluids as efficiently as before surgery.

2. What is short bowel syndrome?

Short bowel syndrome is a collection of symptoms that occur while the rest of your intestines have not yet adapted after surgery to remove part of your bowel. People with short bowel syndrome often have the following symptoms:
Bloating, mild abdominal distension. Cramp . Diarrhea, loose or watery stools. Have a bowel movement right after a meal or several times a day. The body is dehydrated, urinating less, the skin is dry and feeling thirsty all the time. Weight loss.

3. How should people with short bowel syndrome eat?

Diet in short bowel syndrome is an extremely important part for patients who are waiting for the intestines to recover from surgery.
Here are some nutritional guidelines for patients with short bowel syndrome that you can refer to and follow, including:
Eat small meals throughout the day: People with short bowel syndrome should eat 6-8 small meals a day. Eating small, regular meals puts less strain on the rest of your intestines. In addition, small meals also help control symptoms of short bowel syndrome, and increase the ability of the intestine to absorb and digest. A rule when eating that you need to keep in mind: Eat slowly and chew thoroughly. When the rest of the intestines have adapted better, you can return to eating 3 main meals a day. Drink less water with meals: Drinking large amounts of liquids while eating can cause food to pass through the intestinal tract more quickly. This will make it difficult for your body to properly digest or absorb nutrients. Ideally, you should not drink a lot of water with meals. In addition to roughage, your total water intake for each meal should be at most 120ml, equivalent to half a cup of rice. If your meal includes dishes such as soup or soup, you should divide this amount of liquid evenly while eating, avoid drinking large amounts at once. In general, you should drink water or other liquids at least 1 hour before or after a meal. Ensure adequate supply of nutrients to the body: A nutritional regimen for patients with short bowel syndrome should include the following food groups: Protein-rich foods, including fish, eggs , peanut butter, tofu, poultry, pork, beef, lamb and dairy products

Foods high in refined complex carbohydrates or low in fiber (starch), including white bread, peeled potatoes, sweet potatoes, cereals, white rice, pasta, vermicelli or noodles. In the diet for patients with short bowel syndrome, there should be about 750kcal of carbohydrates for a person weighing 50kg. Consume foods that contain fat in moderation, including oils, butter, margarine, mayonnaise, cream sauces, salad dressings and dips. For example, you could have a toast with a bit of butter or a sandwich with mayonnaise. However, you should avoid consuming fatty foods such as deep fried foods. If you have had a large ileum removed, you should eat fatty foods in the morning rather than later in the day. Limit foods high in sugar, including corn syrup, cookies, cakes, chocolate, candy, soda, fruit drinks, honey and malt. You can use artificial sweeteners like Sweet N' Low ® and Splenda ® . However, you should limit your intake of sugar-free candy or cough drops that contain sugar alcohols such as xylitol, sorbitol, isomalt and mannitol. Consuming large amounts of these foods can have a laxative effect, causing you to have more bowel movements. Drink enough water for the body: People with short bowel syndrome should drink at least 8 glasses of water every day. In addition, drinks that are too hot or too cold should be avoided. You should also choose beverages that are low in sugar to limit dehydration, such as coffee, water, tea, milk or diluted fruit juice. However, in some cases, you should be careful when drinking coffee because it has a laxative effect.

4. Some special notes for patients with short bowel syndrome

For people with lactose intolerance: Lactose is a type of sugar found mainly in milk and dairy products. People with lactose intolerance often experience symptoms such as gas, bloating, loose stools, cramps or anal pain. These noticeable signs usually begin to occur within 30 minutes after you consume dairy products. For this condition, it's best to stick to a low-lactose diet or use lactose-free dairy products. Follow a low oxalate diet after an ileostomy: If you've had an ileostomy and still have part of your colon intact, you should adopt a low oxalate diet. In fact, oxalate is a substance that can cause kidney stones. Therefore, you should avoid consuming foods or beverages rich in oxalates such as sweet potatoes, celery, carbonated soft drinks, tea, coffee, nuts, green vegetables, soy products, tangerines, etc. berries, radishes and wheat germ. Choose the right type of fiber: For those who have just undergone surgery, it is not advisable to choose foods containing insoluble fiber, such as vegetables, brown rice, whole grains, because they are often difficult. digestion and make stools bulkier. Instead, you should choose foods that contain soluble fiber as it is generally better tolerated, helps slow down digestion and puts less pressure on your intestines. Foods rich in soluble fiber include dried nuts, fruits, oats, barley, beans, soybeans, kidney beans, and lentils. Eat vegetables properly: After surgery, it will be difficult for your intestines to digest raw vegetables well. Ideally, you should only eat vegetables that have been cooked and should only be consumed about 1⁄2 cups at first, then gradually increase the amount if digestive symptoms improve. When the intestines have gradually stabilized and adapted, you can try eating some raw vegetables. Some vegetables that you should avoid consuming immediately after surgery include spinach, peeled potatoes, carrots, lettuce, peeled cucumbers, cabbage, broccoli, cauliflower, onions, corn, kale, peas and green beans. Vitamin and mineral supplements: To make sure your body gets all the essential vitamins and minerals you need, you can take a multivitamin every day. However, multivitamins need to be taken at the appropriate recommended daily dose (RDA).

For a long ileal resection, you may need to supplement with water-soluble forms of vitamins A, D, and E. If the last part of your ileum is removed, you will need vitamin B12 injections every 1 to 3 months.
Alternatively, you can also add calcium if a long ileum has been removed but the colon is still intact. In case of diarrhea, potassium and zinc supplements can help you improve this condition. However, you absolutely should not arbitrarily supplement potassium without the prescription of the doctor because they can affect your heart rate.
Oral rehydration solution: If you have severe diarrhea, you can drink a rehydration solution to replace lost fluids, such as sodium and potassium. Liquid nutritional supplements: If your weight has dropped, you should supplement with high-calorie liquid nutrients. However, the choice of supplements will depend on many different factors, including the type of surgery, metabolic disorders, or malnutrition patterns. >>See more: Nutrition therapy for short bowel syndrome in adult patients - Posted by Doctor Mai Vien Phuong - Department of Medical Examination & Internal Medicine - Vinmec Central Park International General Hospital

5. Guidelines for keeping a food diary for people with short bowel syndrome

Keeping a daily food diary is one of the best ways to help patients with short bowel syndrome determine which foods are best for them. In your food diary, you need to note the following information:
When you eat main meals or snacks. The time you drink water or other liquids. The name of the food or drink that you consume. How much food or drink you have eaten. Symptoms of the body after surgery. Track your bowel movements for a week or a month. Please follow the website: Vinmec.com regularly to update many other useful information.

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Reference articles: mskcc.org, yhoccongdong.com