The Pharmacologic Treatment of Short Bowel Syndrome: New Tricks and Novel Agents


Short bowel syndrome (SBS) is a manifestation of massive resection of the intestines resulting in severe fluid, electrolyte, and vitamin/mineral deficiencies. Diet and parenteral nutrition play a large role in the management of SBS; however, pharmacologic options are becoming more readily available. These pharmacologic agents focus on reducing secretions and stimulating intestinal adaptation. The choice of medication is highly dependent on the patient’s symptoms, remaining anatomy, and risk versus benefit profile for each agent. This article focuses on common and novel pharmacologic medications used in SBS, including expert advice on their indications and use.

This is a preview of subscription content, access via your institution.

Fig. 1


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.••

    Buchman AL, Scolapio J, Fryer J. AGA technical review on short bowel syndrome and intestinal transplantation. Gastroenterology. 2003;124(12671904):1111–34. Excellent review on the treatment of short bowel syndrome by the AGA.

    PubMed  Article  Google Scholar 

  2. 2.

    Seetharam P, Rodrigues G. Short bowel syndrome: a review of management options. Saudi J Gastroenterol. 2011;17(21727727):229–35.

    PubMed Central  PubMed  Google Scholar 

  3. 3.

    Vanderhoof JA, Kollman KA, Griffin S, Adrian TE. Growth hormone and glutamine do not stimulate intestinal adaptation following massive small bowel resection in the rat. J Pediatr Gastroenterol Nutr. 1997;25(9285386):327–31.

    CAS  PubMed  Article  Google Scholar 

  4. 4.

    DiBaise JK, Young RJ, Vanderhoof JA. Intestinal rehabilitation and the short bowel syndrome: part 1. Am J Gastroenterol. 2004;99(7):1386–95. doi:10.1111/j.1572-0241.2004.30345.x.

    PubMed  Article  Google Scholar 

  5. 5.

    Bakker H, Bozzetti F, Staun M, Leon-Sanz M, Hebuterne X, Pertkiewicz M, et al. Home parenteral nutrition in adults: a European multicentre survey in 1997. ESPEN-Home Artificial Nutrition Working Group. Clin Nutr. 1999;18(3):135–40. doi:10.1054/clnu.1999.0021.

    CAS  PubMed  Article  Google Scholar 

  6. 6.

    Thompson JS, Ferguson DC. Effect of the distal remnant on ileal adaptation. J Gastrointest Surg. 2000;4(11058863):430–4.

    CAS  PubMed  Article  Google Scholar 

  7. 7.

    Wales PW, de Silva N, Kim J, Lecce L, To T, Moore A. Neonatal short bowel syndrome: population-based estimates of incidence and mortality rates. J Pediatr Surg. 2004;39(15137001):690–5.

    PubMed  Article  Google Scholar 

  8. 8.

    Thompson JS, Rochling FA, Weseman RA, Mercer DF. Current management of short bowel syndrome. Curr Probl Surg. 2012;49(22244264):52–5115.

    PubMed  Article  Google Scholar 

  9. 9.••

    Nightingale J, Woodward JM. Guidelines for management of patients with a short bowel. Gut. 2006;55(Suppl 4(16837533)):1–12. Guidelines dedicated to the treatment of patients with short bowel syndrome. Included both nutritional and pharmacologic approaches.

    Google Scholar 

  10. 10.

    Jeong SH, Lee HJ, Bae HJ, Kim Y, Yoo MW, Yoon YK, et al. Factors affecting postoperative dietary adaptation in short bowel syndrome. Hepatogastroenterology. 2009;56(93):1049–52.

    PubMed  Google Scholar 

  11. 11.

    McDuffie LA, Bucher BT, Erwin CR, Wakeman D, White FV, Warner BW. Intestinal adaptation after small bowel resection in human infants. J Pediatr Surg. 2011;46(21683196):1045–51.

    PubMed Central  PubMed  Article  Google Scholar 

  12. 12.

    Schmidt T, Pfeiffer A, Hackelsberger N, Widmer R, Meisel C, Kaess H. Effect of intestinal resection on human small bowel motility. Gut. 1996;38(8984024):859–63.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  13. 13.

    De Francesco A, Malfi G, Delsedime L, David E, Pera A, Serra R, et al. Histological findings regarding jejunal mucosa in short bowel syndrome. Transplant Proc. 1994;26(8029987):1455–6.

    PubMed  Google Scholar 

  14. 14.

    Hofmann AF, Poley JR. Role of bile acid malabsorption in pathogenesis of diarrhea and steatorrhea in patients with ileal resection. I. Response to cholestyramine or replacement of dietary long chain triglyceride by medium chain triglyceride. Gastroenterology. 1972;62(5):918–34.

    CAS  PubMed  Google Scholar 

  15. 15.

    Jeejeebhoy KN. Short bowel syndrome: a nutritional and medical approach. CMAJ. 2002;166(10):1297–302.

    PubMed Central  PubMed  Google Scholar 

  16. 16.

    O’Keefe SJ, Buchman AL, Fishbein TM, Jeejeebhoy KN, Jeppesen PB, Shaffer J. Short bowel syndrome and intestinal failure: consensus definitions and overview. Clin Gastroenterol Hepatol. 2006;4(1):6–10. doi:10.1016/j.cgh.2005.10.002.

    PubMed  Article  Google Scholar 

  17. 17.

    Harper AA, Reed JD, Smy JR. The effects of hyperosmolar solutions placed within the stomach on the output of gastric acid. J Physiol. 1966;186(2):89P–90.

    CAS  PubMed  Google Scholar 

  18. 18.

    Beaugerie L, Carbonnel F, Hecketsweiler B, Dechelotte P, Gendre JP, Cosnes J. Effects of an isotonic oral rehydration solution, enriched with glutamine, on fluid and sodium absorption in patients with a short-bowel. Aliment Pharmacol Ther. 1997;11(4):741–6.

    CAS  PubMed  Article  Google Scholar 

  19. 19.

    Beaugerie L, Cosnes J, Verwaerde F, Dupas H, Lamy P, Gendre JP, et al. Isotonic high-sodium oral rehydration solution for increasing sodium absorption in patients with short-bowel syndrome. Am J Clin Nutr. 1991;53(3):769–72.

    CAS  PubMed  Google Scholar 

  20. 20.

    Lennard-Jones JE. Oral rehydration solutions in short bowel syndrome. Clin Ther. 1990;12(Suppl A):129–37. discussion 38.

    PubMed  Google Scholar 

  21. 21.

    Ladefoged K, Olgaard K. Sodium homeostasis after small-bowel resection. Scand J Gastroenterol. 1985;20(3):361–9.

    CAS  PubMed  Article  Google Scholar 

  22. 22.

    Care AD, Keynes WM. The role of parathyroid hormones in the absorption of calcium and magnesium from the small intestine. Proc R Soc Med. 1964;57:867–8.

    CAS  PubMed Central  PubMed  Google Scholar 

  23. 23.

    Engelhardt W, Schuhmann R, Schwille PO, Geus A. The role of parathyroid hormone and calcitonin in magnesium absorption in the rat small intestine. Experientia. 1983;39(4):425–7.

    CAS  PubMed  Article  Google Scholar 

  24. 24.

    Awouters F, Niemegeers CJ, Janssen PA. Pharmacology of antidiarrheal drugs. Annu Rev Pharmacol Toxicol. 1983;23:279–301. doi:10.1146/

    CAS  PubMed  Article  Google Scholar 

  25. 25.

    Remington M, Malagelada JR, Zinsmeister A, Fleming CR. Abnormalities in gastrointestinal motor activity in patients with short bowels: effect of a synthetic opiate. Gastroenterology. 1983;85(3):629–36.

    CAS  PubMed  Google Scholar 

  26. 26.

    Remington M, Fleming CR, Malagelada JR. Inhibition of postprandial pancreatic and biliary secretion by loperamide in patients with short bowel syndrome. Gut. 1982;23(7068042):98–9101.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  27. 27.

    Caldara R, Cambielli M, Masci E, Guslandi M, Barbieri C, Ferrari C. Effect of loperamide and naloxone on gastric acid secretion in healthy man. Gut. 1981;22(7297919):720–3.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  28. 28.•

    Goke M, Ewe K, Donner K, Buschenfelde KH M. Influence of loperamide and loperamide oxide on the anal sphincter. A manometric study. Dis Colon Rectum. 1992;35(1511646):857–61. Article showing that loperamide may influence anal sphincter tone.

    CAS  PubMed  Article  Google Scholar 

  29. 29.

    Read M, Read NW, Barber DC, Duthie HL. Effects of loperamide on anal sphincter function in patients complaining of chronic diarrhea with fecal incontinence and urgency. Dig Dis Sci. 1982;27(7105952):807–14.

    CAS  PubMed  Article  Google Scholar 

  30. 30.

    Rattan S, Culver PJ. Influence of loperamide on the internal anal sphincter in the opossum. Gastroenterology. 1987;93(3582899):121–8.

    CAS  PubMed  Google Scholar 

  31. 31.

    Schinkel AH, Wagenaar E, Mol CA, van Deemter L. P-glycoprotein in the blood–brain barrier of mice influences the brain penetration and pharmacological activity of many drugs. J Clin Invest. 1996;97(8647944):2517–24.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  32. 32.

    Sadeque AJ, Wandel C, He H, Shah S, Wood AJ. Increased drug delivery to the brain by P-glycoprotein inhibition. Clin Pharmacol Ther. 2000;68(11014404):231–7.

    CAS  PubMed  Article  Google Scholar 

  33. 33.

    Tayrouz Y, Ganssmann B, Ding R, Klingmann A, Aderjan R, Burhenne J, et al. Ritonavir increases loperamide plasma concentrations without evidence for P-glycoprotein involvement. Clin Pharmacol Ther. 2001;70(11719726):405–14.

    CAS  PubMed  Article  Google Scholar 

  34. 34.

    Coupar IM, De Luca A. Opiate and opiate antidiarrhoeal drug action on rat isolated intestine. J Auton Pharmacol. 1994;14(8150811):69–78.

    CAS  PubMed  Article  Google Scholar 

  35. 35.

    Stern J, Ippoliti C. Management of acute cancer treatment-induced diarrhea. Semin Oncol Nurs. 2003;19(4 Suppl 3):11–6.

    PubMed  Article  Google Scholar 

  36. 36.

    Cheetham M, Brazzelli M, Norton C, Glazener CM. Drug treatment for faecal incontinence in adults. Cochrane Database Syst Rev. 2003;3, CD002116. doi:10.1002/14651858.CD002116.

    PubMed  Google Scholar 

  37. 37.

    Pardi DS, Ramnath VR, Loftus Jr EV, Tremaine WJ, Sandborn WJ. Lymphocytic colitis: clinical features, treatment, and outcomes. Am J Gastroenterol. 2002;97(11):2829–33. doi:10.1111/j.1572-0241.2002.07030.x.

    PubMed  Article  Google Scholar 

  38. 38.

    McCarron MM, Challoner KR, Thompson GA. Diphenoxylate-atropine (Lomotil) overdose in children: an update (report of eight cases and review of the literature). Pediatrics. 1991;87(2020516):694–700.

    CAS  PubMed  Google Scholar 

  39. 39.

    Abraham B, Sellin JH. Drug-induced diarrhea. Curr Gastroenterol Rep. 2007;9(5):365–72.

    PubMed  Article  Google Scholar 

  40. 40.

    Hofmann AF. Bile acids, diarrhea, and antibiotics: data, speculation, and a unifying hypothesis. J Infect Dis. 1977;135(Suppl):S126–32.

    PubMed  Article  Google Scholar 

  41. 41.

    King RF, Norton T, Hill GL. A double-blind crossover study of the effect of loperamide hydrochloride and codeine phosphate on ileostomy output. Aust N Z J Surg. 1982;52(2):121–4.

    CAS  PubMed  Article  Google Scholar 

  42. 42.

    Cruz-Correa M, Giardiello FM. Lymphocytic and collagenous colitis. Curr Treat Options Gastroenterol. 2000;3(11097741):243–8.

    PubMed  Article  Google Scholar 

  43. 43.

    Barowsky H, Schwartz SA. Method for evaluating diphenoxylate hydrochloride. Comparison of its antidiarrheal effect with that of camphorated tincture of opium. JAMA. 1962;180:1058–61.

    CAS  PubMed  Article  Google Scholar 

  44. 44.

    Matarese LE, Steiger E. Dietary and medical management of short bowel syndrome in adult patients. J Clin Gastroenterol. 2006;40 Suppl 2:S85–93. doi:10.1097/01.mcg.0000212678.14172.7a.

    CAS  PubMed  Article  Google Scholar 

  45. 45.•

    Bansi DS, Price A, Russell C, Sarner M. Fibrosing colonopathy in an adult owing to over use of pancreatic enzyme supplements. Gut. 2000;46(10644326):283–5. Article describing the rare entity of fibrosing colonopathy in patients on large doses of pancreatic enzymes.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  46. 46.

    FitzSimmons SC, Burkhart GA, Borowitz D, Grand RJ, Hammerstrom T, Durie PR, et al. High-dose pancreatic-enzyme supplements and fibrosing colonopathy in children with cystic fibrosis. N Engl J Med. 1997;336(9113931):1283–9.

    CAS  PubMed  Article  Google Scholar 

  47. 47.

    Jeppesen PB, Staun M, Tjellesen L, Mortensen PB. Effect of intravenous ranitidine and omeprazole on intestinal absorption of water, sodium, and macronutrients in patients with intestinal resection. Gut. 1998;43(9824602):763–9.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  48. 48.

    Sleisenger MH, Feldman M, Friedman LS, Brandt LJ. Sleisenger and Fordtran’s gastrointestinal and liver disease: pathophysiology, diagnosis, management. 9th ed. Philadelphia, PA: Saunders/Elsevier; 2010.

    Google Scholar 

  49. 49.

    Nightingale JM, Walker ER, Farthing MJ, Lennard-Jones JE. Effect of omeprazole on intestinal output in the short bowel syndrome. Aliment Pharmacol Ther. 1991;5(4):405–12.

    CAS  PubMed  Article  Google Scholar 

  50. 50.

    Ladefoged K, Christensen KC, Hegnhoj J, Jarnum S. Effect of a long acting somatostatin analogue SMS 201–995 on jejunostomy effluents in patients with severe short bowel syndrome. Gut. 1989;30(2668129):943–9.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  51. 51.

    Nightingale JM, Walker ER, Burnham WR, Farthing MJ, Lennard-Jones JE. Octreotide (a somatostatin analogue) improves the quality of life in some patients with a short intestine. Aliment Pharmacol Ther. 1989;3(4):367–73.

    CAS  PubMed  Article  Google Scholar 

  52. 52.

    O’Keefe SJ, Peterson ME, Fleming CR. Octreotide as an adjunct to home parenteral nutrition in the management of permanent end-jejunostomy syndrome. JPEN J Parenter Enteral Nutr. 1994;18(1):26–34.

    PubMed  Article  Google Scholar 

  53. 53.

    Nehra V, Camilleri M, Burton D, Oenning L, Kelly DG. An open trial of octreotide long-acting release in the management of short bowel syndrome. Am J Gastroenterol. 2001;96(5):1494–8. doi:10.1111/j.1572-0241.2001.03803.x.

    CAS  PubMed  Article  Google Scholar 

  54. 54.

    Baudet S, Medina C, Vilaseca J, Guarner L, Sureda D, Andreu J, et al. Effect of short-term octreotide therapy and total parenteral nutrition on the development of biliary sludge and lithiasis. Hepatogastroenterology. 2002;49(45):609–12.

    CAS  PubMed  Google Scholar 

  55. 55.

    Moser AJ, Giurgiu DI, Morgenstern KE, Abedin ZR, Roslyn JJ, Abedin MZ. Octreotide stimulates Ca++ secretion by the gallbladder: a risk factor for gallstones. Surgery. 1999;125(10330939):509–13.

    CAS  PubMed  Article  Google Scholar 

  56. 56.

    Harris AG, O’Dorisio TM, Woltering EA, Anthony LB, Burton FR, Geller RB, et al. Consensus statement: octreotide dose titration in secretory diarrhea. Diarrhea Management Consensus Development Panel. Dig Dis Sci. 1995;40(7):1464–73.

    CAS  PubMed  Article  Google Scholar 

  57. 57.

    Homaidan FR, Torres A, Donowitz M, Sharp GW. Electrolyte transport in piglets infected with transmissible gastroenteritis virus. Stimulation by verapamil and clonidine. Gastroenterology. 1991;101(4):895–901.

    CAS  PubMed  Google Scholar 

  58. 58.

    Anderson M, Burleigh D. Imidazolines inhibit secretory responses of rat colonic mucosa to calcium-dependent but not cyclic AMP-dependent secretagogues. J Pharm Pharmacol. 2001;53(2):213–7.

    CAS  PubMed  Article  Google Scholar 

  59. 59.

    Lam RS, App EM, Nahirney D, Szkotak AJ, Vieira-Coelho MA, King M, et al. Regulation of Cl- secretion by alpha2-adrenergic receptors in mouse colonic epithelium. J Physiol. 2003;548(Pt 2):475–84. doi:10.1113/jphysiol.2002.036806.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  60. 60.

    McDoniel K, Taylor B, Huey W, Eiden K, Everett S, Fleshman J, et al. Use of clonidine to decrease intestinal fluid losses in patients with high-output short-bowel syndrome. JPEN J Parenter Enteral Nutr. 2004;28(4):265–8.

    PubMed  Article  Google Scholar 

  61. 61.

    Buchman AL, Fryer J, Wallin A, Ahn CW, Polensky S, Zaremba K. Clonidine reduces diarrhea and sodium loss in patients with proximal jejunostomy: a controlled study. JPEN J Parenter Enteral Nutr. 2006;30(6):487–91.

    CAS  PubMed  Article  Google Scholar 

  62. 62.

    Rhoads JM, Keku EO, Quinn J, Woosely J, Lecce JG. L-glutamine stimulates jejunal sodium and chloride absorption in pig rotavirus enteritis. Gastroenterology. 1991;100(3):683–91.

    CAS  PubMed  Google Scholar 

  63. 63.

    Tamada H, Nezu R, Matsuo Y, Imamura I, Takagi Y, Okada A. Alanyl glutamine-enriched total parenteral nutrition restores intestinal adaptation after either proximal or distal massive resection in rats. JPEN J Parenter Enteral Nutr. 1993;17(3):236–42.

    CAS  PubMed  Article  Google Scholar 

  64. 64.

    Lund PK, Ulshen MH, Rountree DB, Selub SE, Buchan AM. Molecular biology of gastrointestinal peptides and growth factors: relevance to intestinal adaptation. Digestion. 1990;46 Suppl 2:66–73.

    CAS  PubMed  Article  Google Scholar 

  65. 65.

    Ellegard L, Bosaeus I, Nordgren S, Bengtsson BA. Low-dose recombinant human growth hormone increases body weight and lean body mass in patients with short bowel syndrome. Ann Surg. 1997;225(1):88–96.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  66. 66.

    Seguy D, Vahedi K, Kapel N, Souberbielle JC, Messing B. Low-dose growth hormone in adult home parenteral nutrition-dependent short bowel syndrome patients: a positive study. Gastroenterology. 2003;124(2):293–302. doi:10.1053/gast.2003.50057.

    CAS  PubMed  Article  Google Scholar 

  67. 67.

    Byrne TA, Persinger RL, Young LS, Ziegler TR, Wilmore DW. A new treatment for patients with short-bowel syndrome. Growth hormone, glutamine, and a modified diet. Ann Surg. 1995;222(3):243–54.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  68. 68.

    Byrne TA, Wilmore DW, Iyer K, Dibaise J, Clancy K, Robinson MK, et al. Growth hormone, glutamine, and an optimal diet reduces parenteral nutrition in patients with short bowel syndrome: a prospective, randomized, placebo-controlled, double-blind clinical trial. Ann Surg. 2005;242(5):655–61.

    PubMed Central  PubMed  Article  Google Scholar 

  69. 69.

    Szkudlarek J, Jeppesen PB, Mortensen PB. Effect of high dose growth hormone with glutamine and no change in diet on intestinal absorption in short bowel patients: a randomised, double blind, crossover, placebo controlled study. Gut. 2000;47(2):199–205.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  70. 70.

    Scolapio JS, Camilleri M, Fleming CR, Oenning LV, Burton DD, Sebo TJ, et al. Effect of growth hormone, glutamine, and diet on adaptation in short-bowel syndrome: a randomized, controlled study. Gastroenterology. 1997;113(4):1074–81.

    CAS  PubMed  Article  Google Scholar 

  71. 71.••

    Wales PW, Nasr A, de Silva N, Yamada J. Human growth hormone and glutamine for patients with short bowel syndrome. The Cochrane database of systematic reviews. 2010 (6):CD006321. doi:10.1002/14651858.CD006321.pub2. Systematic review concentrating on the use of growth hormone with glutamine for patients with short bowel syndrome.

  72. 72.•

    Jeppesen PB, Hartmann B, Thulesen J, Graff J, Lohmann J, Hansen BS, et al. Glucagon-like peptide 2 improves nutrient absorption and nutritional status in short-bowel patients with no colon. Gastroenterology. 2001;120(4):806–15. First major study on GLP-2 in patients with short bowel syndrome.

    CAS  PubMed  Article  Google Scholar 

  73. 73.

    Haderslev KV, Jeppesen PB, Hartmann B, Thulesen J, Sorensen HA, Graff J, et al. Short-term administration of glucagon-like peptide-2. Effects on bone mineral density and markers of bone turnover in short-bowel patients with no colon. Scand J Gastroenterol. 2002;37(4):392–8.

    CAS  PubMed  Article  Google Scholar 

  74. 74.

    Jeppesen PB, Sanguinetti EL, Buchman A, Howard L, Scolapio JS, Ziegler TR, et al. Teduglutide (ALX-0600), a dipeptidyl peptidase IV resistant glucagon-like peptide 2 analogue, improves intestinal function in short bowel syndrome patients. Gut. 2005;54(9):1224–31. doi:10.1136/gut.2004.061440.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  75. 75.

    Jeppesen PB, Gilroy R, Pertkiewicz M, Allard JP, Messing B, O’Keefe SJ. Randomised placebo-controlled trial of teduglutide in reducing parenteral nutrition and/or intravenous fluid requirements in patients with short bowel syndrome. Gut. 2011;60(7):902–14. doi:10.1136/gut.2010.218271.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  76. 76.

    Jeppesen PB, Pertkiewicz M, Messing B, Iyer K, Seidner DL, O’Keefe SJ, et al. Teduglutide reduces need for parenteral support among patients with short bowel syndrome with intestinal failure. Gastroenterology. 2012;143(6):1473–81. doi:10.1053/j.gastro.2012.09.007. e3.

    CAS  PubMed  Article  Google Scholar 

  77. 77.••

    O'Keefe SJ, Jeppesen PB, Gilroy R, Pertkiewicz M, Allard JP, Messing B. Safety and efficacy of teduglutide after 52 weeks of treatment in patients with short bowel intestinal failure. Clin Gastroenterol Hepatol. 2013;11(7):815–23 e1-3. doi:10.1016/j.cgh.2012.12.029. Long-term study showing the effects of teduglutide for reduction of parenteral volume in patients with short bowel syndrome.

    PubMed  Article  Google Scholar 

  78. 78.

    Seidner DL, Schwartz LK, Winkler MF, Jeejeebhoy K, Boullata JI, Tappenden KA. Increased intestinal absorption in the era of teduglutide and its impact on management strategies in patients with short bowel syndrome-associated intestinal failure. JPEN J Parenter Enteral Nutr. 2013;37(2):201–11. doi:10.1177/0148607112472906.

    PubMed  Article  Google Scholar 

  79. 79.

    Tappenden KA, Edelman J, Joelsson B. Teduglutide enhances structural adaptation of the small intestinal mucosa in patients with short bowel syndrome. J Clin Gastroenterol. 2013;47(7):602–7. doi:10.1097/MCG.0b013e3182828f57.

    CAS  PubMed  Article  Google Scholar 

  80. 80.

  81. 81.

    Kramer P, Levitan R. Effect of 9- -fluorohydrocortisone on the ileal excreta of ileostomized subjects. Gastroenterology. 1972;62(2):235–41.

    CAS  PubMed  Google Scholar 

  82. 82.

    Feretis CB, Vyssoulis GP, Pararas BN, Nissiotis AS, Calaitzopoulos JD, Apostolidis NS, et al. The influence of corticosteroids on ileostomy discharge of patients operated for ulcerative colitis. Am Surg. 1984;50(8):433–6.

    CAS  PubMed  Google Scholar 

Download references

Compliance with Ethics Guidelines

Conflict of Interest

Matthew L. Bechtold is a consultant for Nestle. Lena B. Palmer, Douglas L. Nguyen, Lindsay M. Urben, Robert G. Martindale, and Ryan T. Hurt have nothing to disclose.

Steven A. McClave is a consultant for Covidien and has received research grants from Abbot and Nestle.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by the author.

Author information



Corresponding author

Correspondence to Stephen A. McClave.

Additional information

This article is part of the Topical Collection on Nutrition and Obesity

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Bechtold, M.L., McClave, S.A., Palmer, L.B. et al. The Pharmacologic Treatment of Short Bowel Syndrome: New Tricks and Novel Agents. Curr Gastroenterol Rep 16, 392 (2014).

Download citation


  • Small bowel syndrome
  • Pharmacology
  • Malabsorption
  • Treatment
  • Review