Chapter 3 - Fluids and Electrolytes: Challenges With Short Bowel Syndrome

Abstract

Optimizing fluid and electrolyte status is the cornerstone of short bowel syndrome (SBS) management. Careful attention to fluid and electrolyte status is essential to not only avoid life-threatening complications but also to minimize clinical interventions, to maximize the chance of success in weaning off intravenous fluids or parenteral nutrition, and above all to improve a patient’s quality of life. The optimal management of fluids and electrolytes in patients with SBS is not only a function of proper and adequate administration of fluids and electrolytes but also of a comprehensive multidisciplinary approach that includes diet modification and pharmacologic agents. Because SBS disease severity encompasses a heterogeneous population, the spectrum of needs for fluid and electrolytes is broad and depends on many factors including length, location, and functional capacity of remnant bowel and phase of adaptation since resection, in addition to a patient’s ability to incorporate dietary and pharmacologic interventions. This chapter will focus on patient-specific factors that challenge fluid and electrolyte status and specific management approaches for fluids and electrolytes, along with select micronutrients, in patients with SBS.