What is the function of the small bowel?

The gastrointestinal system includes your mouth, esophagus, stomach, small bowel (small intestine), colon (large intestine), rectum and anus. The basic function of the system is to absorb nutrients and water, and to carry waste products out of the body.

Your small bowel has three parts:

1. Duodenum: the part that attaches to the stomach
2. Jejunum: the middle part of the small bowel
3. Ileum: the part that attaches to the colon (large intestine)

In your small bowel, water and nutrients are absorbed through the intestinal walls. They are absorbed into the blood stream and into the various parts of your body to help your body function. The small bowel does not absorb undigested food and fiber. Instead, they are pushed from the small bowel to the colon, where the body slowly moves them through the colon to the rectum until the body eliminates them through the anus as a bowel movement.

If your short bowel is damaged by disease or trauma, then you may have intestinal failure.

What is intestinal failure?

Intestinal failure is the loss of the absorptive capacity of the small bowel. A common cause for children is short gut syndrome, a congenital disorder in which an infant's intestine is too short or underdeveloped to allow normal food digestion. Adults with small bowel disease often have undergone prior surgery, has part of the intestine removed, or have developed a problem with the motility of the intestine. These problems require a patient to live on intravenous feeding or TPN (total parenteral nutrition). Among other causes are:

• Abdominal trauma
• Crohn's disease
• Clotting of the blood vessels to the small bowel
• Surgical adhesions
• Surgical Resection of the intestine
• Congenital anomalies
• Necrotizing Enterocolitis
• Enterocyte disorders such as microvillous disease or Tufting enteropathy

What are the symptoms of small bowel disease?

Most patients with short bowel syndrome develop diarrhea, dehydration and require an intravenous line for hydration and nutrition. Patients with motility disorders often experience bloating, abdominal distension and vomiting, and have trouble eating.

What are some common small bowel diseases?

Common small bowel diseases include:

• Inflammatory bowel disease
• Crohn’s disease or other forms of IBD (inflammatory bowel disease)
• Short Gut Syndromes
• Malabsorption Syndromes
• Motility Disorders
• Tumors of the Intestinal Mesentery

How do I manage my small bowel disease?

If your small bowel is not working well enough to absorb the fluid and nutrition you need on a daily basis, you are probably on TPN (Total Parenteral Nutrition). TPN is a liquid filled with all the nutrients your body needs to survive, given through a central line right into the blood stream. By putting nutrients right into the blood stream, TPN does the job of the small bowel. However, this is not a long-term solution for most patients. We may recommend a small bowel transplant. Learn more about The Center for Intestinal Care and Transplant program, where our doctors focus on treating small bowel disease.

What if I need a transplant?

Our small bowel transplant team members are all dedicated to supporting our transplant patients, from their first steps in their journey to transplantation, to managing their healthy organ for life.

What is small bowel transplant and how does it help the patient?

Small bowel transplantation is the transplantation of a new intestine to an individual with irreversible intestinal failure. The purpose of this transplant is to restore intestinal function so patients can eat again, and not require TPN. It is used to treat intestinal failure when other treatments, such as parenteral nutrition (intravenous tube feeding or TPN) are not successful.

Why Georgetown for my small bowel transplant?

• Expertise: Our small bowel transplant team manages about 100 small bowel transplant a year. 60-70 of those are for children 18 and younger.
• Teamwork: our staff displays remarkable teamwork and offers patients the best possible care from a Transplant Team of different health professionals.
• Availability: a transplant surgeon is on call 24 hours a day, seven days a week to evaluate organs for potential transplantation