Short Bowel Syndrome Diet

Last Modified: September 8, 2006

Dear OncoLink "Ask The Experts,"

I suffer from short bowel syndrome (SBS) due to extensive resection of my small intestines following damage caused by radiation therapy. I have been cancer free for the past 6 years. However, I have had a difficult time gaining weight after my initial loss of 25 pounds. I eat 5 small meals every day, or approximately 2000 calories. I use a supplement (Boost) as one of my snacks. I have periodic bouts of diarrhea, but recently they have been less in volume and frequency due to, I believe, the removal of my gall bladder in January of this year. I continue to search out specialists who might offer some suggestions as to diets that could produce some weight gain.

Katrina Claghorn, MS, RD, Registered Dietitian at the Abramson Cancer Center of the University of Pennsylvania, responds:

From what you describe, you are already following the general dietary recommendations for Short Bowel Syndrome ( SBS ). It is a very difficult diet regimen since patients feel as though they are eating all the time just to maximize their intake.

Diet guidelines for SBS include:

Increase complex carbohydrates (potatoes, bread, pretzels, crackers, pasta). Keep a bowl of pretzels or crackers on your desk to nibble on throughout the day. Simple carbohydrates are often not as well tolerated.
Increase your fat intake since fat is high in calories. Add butter, olive oil, cheese, and bacon bits to foods. Fat tolerance varies greatly in SBS. Some people can eat fat without experiencing any GI problems, while others experience diarrhea. Since most people with SBS have low cholesterol, additional fat is not a problem. However, if you are concerned, you can have your doctor check cholesterol levels periodically.
Don't' fill up on liquids before or during meals. Limit your fluid intake to sips, but make sure to consume additional fluids between meals.
When eating meals, consume the higher calorie foods first. Eat the protein and starch, and then later fill up on vegetables and fruits.
You may want to investigate very high calorie supplement drinks that provide about 600 calories per cup e.g. Scandishake, SupliMed and Carnation Breakfast VHC.
If despite all your best efforts you are unable to gain weight, you may want to consider supplemental total parenteral nutrition (IV nutrition).
I would also advise you meet with a Registered Dietitian who specializes in cancer to review your diet and assess your nutritional status. Patients with SBS vary greatly in the foods they can tolerate.

You should also be monitored for possible nutrient deficiencies due to your restricted diet as well as the loss of a portion of your GI tract.

Your cancer center should have a staff dietitian.