Understanding
Short Bowel Syndrome

Roy,
gattex
patient

Short bowel syndrome (SBS) is a serious and chronic malabsorption disorder

SBS occurs when parts of the intestine are removed surgically and the remaining intestine may not be able to absorb enough nutrients from food and drink.

The term “short gut” is sometimes used, but the condition is officially called short bowel syndrome (SBS, for short).

This results in malabsorption. It puts people at risk for:

knife fork malnutrition

Malnutrition

water drop dehydration

Dehydration

electrolyte disturbances

Electrolyte disturbances

bathroom icon diarrhea increased outputs

Diarrhea/increased outputs

There are multiple factors a doctor may use to determine an sbs diagnosis, not just the length of remaining bowel

The causes of SBS can be different in adults and children

SBS in adults often starts with other medical conditions that lead to loss of function and surgical removal of parts of the intestines. These can include:

  • Inflammatory bowel disease (IBD), such as Crohn's disease or ulcerative colitis
  • Vascular events
  • Traumatic injury to the small bowel

Unlike in adults, surgical resection in children is often due to a condition at birth:

  • Necrotizing enterocolitis, commonly referred to as NEC, is the most common cause in premature infants and occurs when the lining of the intestinal wall dies
  • Other conditions at birth include:
    • stomach wall defects (gastroschisis)
    • blockage in the intestine (intestinal atresia)
    • twisting of the intestine (volvulus)
    • missing nerve cells in the intestine (Hirschsprung’s disease)
    • other congenital (birth) defects

Many people with SBS require parenteral support

Parenteral support (PS) is any kind of nutrition and/or fluids that are given through a vein (intravenously).

Based on your personal needs, PS can include a mix of nutrients, such as:

  • Proteins
  • Carbohydrates
  • Fats
  • Vitamins
  • Minerals

Every person with SBS is different, and PS requirements can vary.

People who are dependent on PS have a range of needs, from temporary use of intravenous fluids to total parenteral nutrition (TPN). TPN provides people with all of their daily nutrition.

Treatment goals for people with SBS include:

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Maintaining essential nutrition and hydration

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Helping the intestine adapt so that it can properly digest nutrients and fluids

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Reducing or eliminating the need for long-term PS

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Improving daily life by supporting healthy work, sleep, and social habits

PS provides essential nutrition but does not help the intestine absorb more nutrients

It’s important to understand the role of a hormone called GLP-2

GLP-2 impacts the way the body absorbs nutrients.

GLP-2, short for glucagon-like peptide-2, is a hormone produced in the intestine that helps the body absorb nutrients and fluids. Hormones are chemical messengers that help your body in many different ways.

Want to learn more about a treatment option for SBS?

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What is GATTEX?

GATTEX® (teduglutide) for subcutaneous injection is a prescription medicine used in adults and children 1 year of age and older with Short Bowel Syndrome (SBS) who need additional nutrition or fluids from intravenous (IV) feeding (parenteral support). It is not known if GATTEX is safe and effective in children under 1 year of age.

Important safety information

What is the most important information I should know about GATTEX?

GATTEX may cause serious side effects, including:

Making abnormal cells grow faster

GATTEX can make abnormal cells that are already in your body grow faster. There is an increased risk that abnormal cells could become cancer. If you get cancer of the bowel (intestines), liver, gallbladder or pancreas while using GATTEX, your healthcare provider should stop GATTEX. If you get other types of cancers, you and your healthcare provider should discuss the risks and benefits of using GATTEX.

Polyps in the colon (large intestine)

Polyps are growths on the inside of the colon. Your healthcare provider will have your colon checked for polyps within 6 months before starting GATTEX and have any polyps removed. Children and adolescents will be checked for blood in the stool before they start using GATTEX.

To keep using GATTEX, your healthcare provider should have your colon checked for new polyps at the end of 1 year of using GATTEX. If no polyp is found, your healthcare provider should check you for polyps as needed and at least every 5 years and have any new polyps removed. If cancer is found in a polyp, your healthcare provider should stop GATTEX.

Blockage of the bowel (intestines)

A bowel blockage keeps food, fluids, and gas from moving through the bowels in the normal way. Tell your healthcare provider right away if you have any of these symptoms of a bowel or stomal blockage:

  • trouble having a bowel movement or passing gas
  • stomach area (abdomen) pain or swelling
  • nausea
  • vomiting
  • swelling and blockage of your stoma opening, if you have a stoma

If a blockage is found, your healthcare provider may temporarily stop GATTEX.

Swelling (inflammation) or blockage of your gallbladder or pancreas

Your healthcare provider will do tests to check your gallbladder and pancreas within 6 months before starting GATTEX and at least every 6 months while you are using GATTEX. Tell your healthcare provider right away if you get:

  • stomach area (abdomen) pain and tenderness
  • chills
  • fever
  • a change in your stools
  • nausea
  • vomiting
  • dark urine
  • yellowing of your skin or the whites of your eyes

Fluid overload

Your healthcare provider will check you for too much fluid in your body. Too much fluid in your body may lead to heart failure, especially if you have heart problems. Tell your healthcare provider if you get swelling in your feet and ankles, you gain weight very quickly (water weight), or you have trouble breathing.

The most common side effects of GATTEX in adults include:

  • stomach area (abdomen) pain or swelling
  • nausea
  • cold or flu symptoms
  • skin reaction where the injection was given
  • vomiting
  • swelling of the hands or feet
  • allergic reactions

The side effects of GATTEX in children and adolescents are similar to those seen in adults.

Tell your healthcare provider if you have any side effect that bothers you or that does not go away.

What should I tell my healthcare provider before using GATTEX?

Tell your healthcare provider about all your medical conditions, including if you or your child:

  • have cancer or a history of cancer
  • have or had polyps anywhere in your bowel (intestines) or rectum
  • have heart problems
  • have high blood pressure
  • have problems with your gallbladder, pancreas, kidneys
  • are pregnant or planning to become pregnant. It is not known if GATTEX will harm your unborn baby. Tell your healthcare provider right away if you become pregnant while using GATTEX.
  • are breastfeeding or plan to breastfeed. It is not known if GATTEX passes into your breast milk. You should not breastfeed during treatment with GATTEX. Talk to your healthcare provider about the best way to feed your baby while using GATTEX.

Tell your healthcare providers about all the medicines you take, includin