SpeechPathology.com Phone: 800-242-5183

The Stepping Stones Group - Transforming - February 2021

Short Gut Syndrome

Abby Mathews, MA, CCC-SLP, Luann Stevens, MA, CCC-SLP

January 30, 2017



What is short gut syndrome and how is it managed?


Short gut or short bowel syndrome is a condition that occurs when a large portion of the intestines does not work normally. Either a large section of the bowel has been surgically removed, or a baby is born with abnormal intestines. The complications that frequently occur include failure to thrive, dehydration, and central line infections for patients on TPN (Total Parenteral Nutrition). These dangers are the reason that these patients require close medical and nutritional follow-up.

Intestinal failure is a side effect of short gut syndrome and is defined as the inability to sustain adequate nutritional, electrolyte or hydrational status in the absence of specialized nutritional support (Buchman, 2006). Research conducted by Buchman found that the largest single group of patients who receive home TPN were those with short bowel syndrome. Many medically fragile children require TPN for a variety of reasons, however a child with short guy syndrome will have the TPN for much longer. Of course, the longer the patient needs a PICC line or central line for their TPN, the higher the risk of complications and challenges for the family and patients. Therefore, it is important to transition a patient off of TPN as quickly as possible.

The purpose of intestinal rehabilitation is to help the child grow at an adequate pace. Strategies and therapies are designed to make the bowel work better, including nutrition support, nutritional rehabilitation, medical management or restorative surgery. This is done by using specialized formula, manipulating the rate and schedules of enteral feeds, and balancing feeds, fluids, TPN, IV fluids and enteral feeds. Medications are integrated as needed and surgeries are coordinated when needed as well.  Therapies are constantly readjusted based on whether or not the child is gaining weight, if they have had any additional surgeries, and if their oral skills are advancing.  

In summary, the goal of intestinal rehabilitation is to transition the child off TPN, for the child to tolerate enteral feeds, and maximize oral interest. 

Please refer to the SpeechPathology.com course, The Speech Pathologist's Role with the Pediatric Intestinal Rehabilitation Population, presented in partnership with Cincinnati Children's for more in-depth information about speech pathology services that are beneficial to pediatric patients with short bowel syndrome.

abby mathews

Abby Mathews, MA, CCC-SLP

Abby Mathews is a graduate of the University of Toledo and has been working as a Speech Language Pathologist at Cincinnati Children’s Hospital Medical Center for 7 years.  She currently works as an inpatient therapist on the Gastrointestinal/Colorectal Surgery unit, Complex Surgery and Transplant unit, Oncology/Hematology unit, and Bone Marrow Transplant unit. She treats patients with a variety of feeding and language disorders.  She has previously worked as an outpatient therapist at Cincinnati Children’s Hospital Medical Center and outpatient therapist at a pediatric private practice. 

luann stevens

Luann Stevens, MA, CCC-SLP

Luann Stevens is a graduate of the University of Cincinnati and works as an inpatient Speech Language Pathologist at Cincinnati Children’s Hospital Medical Center, Main Campus.  Her area of interest and expertise is working with patients with feeding difficulties related to complex airway issues, tracheostomy, and aspiration. Another area of specialty is evaluation and treatment of feeding disorders for children with gastrointestinal problems including bowel resection, transplant, reflux and failure to thrive. Luann also performs video swallow studies and FEES examinations. She has been with the Division of Speech Pathology since 1999.

Related Courses

Inpatient Management of Speech and Swallowing After Total Glossectomy
Presented by Jodi Knott, MS, CCC-SLP, BCS-S


Jodi Knott, MS, CCC-SLP, BCS-S
Course: #9768Level: Introductory1 Hour
  'great speaking style'   Read Reviews
This is Part 1 of a two-part series. This course introduces participants to a “road map” for rehabilitation and restoration of speech and swallowing, following a total glossectomy. It discusses postoperative anatomy and physiology and the importance of preoperative counseling, along with approaches to inpatient management and the SLP’s role across the continuum of care.

DIRFloortime®: Beyond Playing on the Floor
Presented by Joleen R. Fernald, PhD, CCC-SLP, BCS-CL


Joleen R. Fernald, PhD, CCC-SLP, BCS-CL
Course: #9642Level: Advanced4 Hours
  'The inclusion of videos was very helpful! Love the diversity of ability levels, too'   Read Reviews
The DIRFloortime® framework can be used not only with children with autism, but with a wide variety of ages and diagnoses. This 4-hour master class describes DIRFloortime principles and concepts such as Functional Emotional Developmental Capacities (FEDCs) and relationship-based intervention. Case studies provide examples of goals and therapy activities, including virtual experiences, for various populations.

20Q: Velo-Cardio-Facial Syndrome (VCFS)
Presented by Karen J. Golding-Kushner, PhD, CCC-SLP, ASHA Fellow


Karen J. Golding-Kushner, PhD, CCC-SLP, ASHA Fellow
Course: #8700Level: Intermediate1 Hour
  'Clear and concise'   Read Reviews
This course describes the characteristics of Velo-cardio-facial syndrome that are of the greatest relevance to SLPs: those that affect feeding, speech and language. Best practice for intervention is also explained.

Dysphagia in Neurodegenerative Disease
Presented by Debra M. Suiter, PhD, CCC-SLP, BCS-S


Debra M. Suiter, PhD, CCC-SLP, BCS-S
Course: #9732Level: Intermediate1 Hour
  'Good introduction to ALS and Parkinson’s and what can occur'   Read Reviews
Dysphagia is common in individuals with amyotrophic lateral sclerosis (ALS) and Parkinson’s disease. This course discusses the underlying pathophysiology and appropriate treatment programs for each disease, as well as use of alternate methods of nutrition/hydration.

Back to Basics: Swallow Screening: How, when, and who
Presented by Angela Mansolillo, MA, CCC-SLP, BCS-S


Angela Mansolillo, MA, CCC-SLP, BCS-S
Course: #8969Level: Introductory1 Hour
  'Concise, practical'   Read Reviews
Screening of swallow function is a well-regarded tool to identify individuals who are potentially at risk of dysphagia and in need of full swallow assessment, but the options are many and varied. This "back to basics" course will teach participants to make informed, evidence-based choices regarding appropriate screening tools specific to their particular patient populations and settings.