# Treatment methods for short bowel syndrome
The goal of treatment for short bowel syndrome (SBS) is to absorb as many nutrients as possible through the intestines, maintain body function, prevent complications, and improve quality of life. The approach is stepwise: first, attempts are made to manage with adapted diet and supportive therapies, and only when that is insufficient, medications or more intensive forms of nutrition are introduced.
Nutritional therapy and nutrition via infusion
The first step in treatment is usually adjusting what and how you eat. A gastroenterologist and dietitian help establish a nutrition plan that matches how much intestine you have and how well it functions. Often, many small meals are given instead of three large ones, so the remaining intestine can absorb better. The type of food is also considered: for example, some people tolerate liquid nutrition better than solid food, and others benefit from nutrition that contains less fat.
ProveniIncluded in official guidelines, or approved by EMA or FDA
When the small intestine does not absorb enough nutrients, nutrition via infusion (total parenteral nutrition, TPN) may be necessary. This is a liquid nutrition delivered directly into a blood vessel, so the body can use it without it having to pass through the intestines. This can be done at home, often in the evening. This provides much freedom during the day, but requires learning to manage the infusion line properly and regular medical supervision. Side effects can occur around the infusion site (infection, blockage) or in the longer term with the liver.
ProveniIncluded in official guidelines, or approved by EMA or FDA
Medications that stimulate the intestines
Medications from the group of GLP-1 analogues can help the remaining intestine function better. They stimulate the intestine to absorb more nutrients and can improve the passage of nutrition through the intestines. These agents come from research into diabetes and obesity, but are also being investigated for short bowel syndrome. They are injected under the skin. Side effects can include nausea, abdominal pain, and changes in gastric emptying.
ResearchediPositive results in clinical studies, not yet standard treatment
Another agent being investigated is glepaglutide. It works similarly to GLP-1 analogues and appears to increase nutrient absorption and improve intestinal function. It is not yet available in all countries outside of trials.
ResearchediPositive results in clinical studies, not yet standard treatment
Support of intestinal function
Some medications help keep the intestines more moist, so nutrition stays in contact with the intestinal mucosa longer and can be absorbed better. This may be relevant for people with significant diarrhea. Agents can also be used that slow the passage of nutrition through the intestines, allowing more time for absorption.
ProveniIncluded in official guidelines, or approved by EMA or FDA
Microbiome support
Research shows that the composition of bacteria in the intestines (the microbiome) is important for nutrient absorption and health. In short bowel syndrome, this microbiome is often dysregulated. Dietitians can advise on food choices that encourage certain beneficial bacteria. It is also being investigated whether nutrients (prebiotics) or bacterial preparations (probiotics) can help, but evidence for this is still limited and the effect varies greatly between individuals.
ResearchediPositive results in clinical studies, not yet standard treatment
Treatment of complications
Prevention of blood clots
Because people with short bowel syndrome receive long-term nutrition via infusion through a blood vessel, there is an increased risk of blood clots around the infusion line. An ESPEN guideline (European nutrition organization) from 2026 recommends regular medical supervision and, where necessary, medications that slow blood clotting. These are the same agents used in other conditions with clotting risk.
ProveniIncluded in official guidelines, or approved by EMA or FDA
Protection of the liver
Long-term total parenteral nutrition can eventually strain the liver (intestinal failure-associated liver disease). Medical monitoring includes regular blood tests. Certain nutritional adjustments can also help, such as adding specific fats or continuing to use as much normal food by mouth as possible, even if this covers only a small part of nutritional needs.
ProveniIncluded in official guidelines, or approved by EMA or FDA
Treatment of high output stoma
Some people have an artificial opening (stoma) after bowel surgery or experience severe diarrhea with significant fluid loss. New research from 2026 shows that certain medications (GLP-1 analogues) can help reduce this fluid loss and stabilize fluid balance.
ResearchediPositive results in clinical studies, not yet standard treatment
Bowel regeneration and surgical options
Bowel lengthening and surgery
In some cases, surgical procedures can help. For example, by freeing up the remaining bowel and stretching it longer, or by restoring blood supply to bowel segments that no longer receive it (revascularization). These are complex procedures that only take place in specialized centers. Recent research shows that a combination of bowel resection (removal of damaged segments) and vascular repair can be beneficial for certain patients.
ProveniIncluded in official guidelines, or approved by EMA or FDA
(in selected cases)
Bowel tissue regeneration
Research into whether damaged bowel can regenerate or 'regrow' is ongoing. This includes the use of growth factors and stem cells, but these treatments are still in the research and experimental phase and are not routinely available.
ExperimentaliOngoing in study setting, outcome still unknown
Supportive Treatment
RELiZORB
This is an investigational product that helps break down protein in the small intestine so it can be better absorbed. A phase 3 trial is underway in 2026. It has not yet been accepted as standard treatment.
ResearchediPositive results in clinical studies, not yet standard treatment
Regular medical monitoring
Because short bowel syndrome can have many consequences (fluid deficiency, mineral deficiencies, liver strain, infections), regular contact with the hospital is important. This includes blood tests, monitoring of weight and dehydration, and discussions about nutrition and quality of life.
ProveniIncluded in official guidelines, or approved by EMA or FDA
Psychosocial support
Living with short bowel syndrome can be emotionally burdensome: it requires considerable attention to nutrition and medical treatment, and can hinder social activities. Support from psychologists, dietitians, and peer support groups can help with adjustments and emotional stress.
ProveniIncluded in official guidelines, or approved by EMA or FDA
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_This information never replaces a doctor's judgment. Always discuss your situation with your own healthcare provider._