There is no single SBS diet. Talk to your doctor or dietician about a nutrition plan that's right for you."

Short Bowel Syndrome (SBS) Diet: Eating & Drinking"

With SBS, Eating & Drinking May Need To Be Strategic

Kevin, a patient
living with SBS

When you have Short Bowel Syndrome, everything you eat and drink MAY NEED TO be carefully considered. Talk to your doctor or dietitian about a nutrition plan that's right for you.



There Is No Single “SBS Diet”

There isn't a single, established diet for people with SBS. Depending on the portion and length of your remaining bowel and how well it functions, your doctor may help create a diet that's tailored to you. Your doctor will likely encourage you to continue eating, if possible, since it can help stimulate the bowel.

If your doctor says it’s ok to eat and drink, you may need to consciously adjust what and how much you eat based on his/her advice.

SBS Nutritional Guidelines

Talk to your doctor or healthcare team about how to improve nutrition and overall health with your diet. Unless otherwise instructed by your doctor, you should generally eat small and frequent meals to help manage certain SBS symptoms and encourage digestion and absorption. You’ll probably need to consume a lot more food and, ultimately, calories than someone with a normal-sized bowel would in order to compensate for your bowel’s inability to absorb nutrients normally.

If you have any remaining colon, you may need to maintain a diet that is low fat, high carbohydrate.

If you have a jejunostomy or an ileostomy, you may need to maintain a diet that is high fat, low carbohydrate and higher in salt.

Remember to always talk to your doctor before changing your diet.

General SBS Eating and Drinking Tips

  • Track everything you eat and drink in a food diary
  • Chew all food thoroughly
    • Try for about 40 chews per bite
  • Eat smaller meals more often
    • Up to six to eight smaller meals each day
    • Space each meal out over the course of the day
    • Eat the most nutritious foods first
  • Limit fluids with meals
    • Drink half a glass of fluid (four oz.) or less at each meal
    • Stick with isotonic beverages, like oral rehydration solutions
  • Separate solids and liquids at meals
    • Eat solid foods first, as they slow down digestion

Remember to talk to your doctor before changing your diet.

General foods to avoid

  • Concentrated sweets
    • We know they’re tempting, but stay away from cookies, cakes, candies, chocolate, fruit drinks, honey and syrups
  • GI stimulants
    • Alcohol and caffeine
  • For patients with a colon, high-oxalate foods
    • Examples include: tea; instant coffee; cola drinks; nuts; soy products; green, leafy vegetables; root vegatables; celery; berries; tangerines; rutabagas and wheat germ
    • These can promote kidney stones
  • Osmotic carbohydrates
    • Fruit juice, colas and simple sugars like cakes, cookies, pies and donuts
    • These can pull water into the GI tract and lead to nutrition loss
  • Difficult-to-digest foods
    • Whole nuts, seeds, coconut, fruit skins/peels and dried fruits

Remember to talk to your doctor before changing your diet.

A Patient's Guide to Managing a Short Bowel by Carol Rees Parrish, MS, RD.

To learn more about SBS-diet strategies and guidelines, talk to your doctor and sign up to receive a copy of A Patient’s Guide to Managing a Short Bowel by Carol Rees Parrish, MS, RD.

When starting your new doctor-approved diet, consider working with a registered dietitian or certified nutrition support clinician to help with meal planning.

Keeping a Food Diary

It might be a good idea to keep a food diary and record what, when and how much food you eat each day. This is a great way to discover trends about which foods agree (and disagree) with your body.

The Centers for Disease Control and Prevention (CDC) has created a blank food diary to help you get started. You can find it by searching "Food Diary" from the CDC's home page search bar. There, you can print out the diary and write down what you eat each day and document how you're feeling.

Don’t hesitate to share your food diary with your doctor and dietitian. Together, you can help pinpoint which foods work best in your diet.

The Dangers of Dehydration

Though there’s a lot to consider when planning your SBS diet, it is just as important to know what and how much you should drink. Dehydration can be a serious concern. However, battling dehydration isn’t a matter of simply drinking more water. In fact, this can make the problem worse by increasing diarrhea or ostomy output.

Signs of Dehydration

  • Thirst
  • Rapid weight loss
  • Not peeing as often as usual
  • Urine that’s dark in color
  • Kidney stones
  • Feeling tired all the time
  • Dry mouth
  • Sticky or thick saliva
  • Your stool is more than your total fluid intake
  • You feel lightheaded when you stand up

Since drinking more water when dehydrated can lead to further dehydration for people with SBS, it’s important to consult your doctor when you notice signs of dehydration. This isn’t a problem that should be ignored! There are therapies and strategies that your healthcare team can use to help you rehydrate. And the sooner your doctor knows of the situation, the sooner you can take the necessary steps to feel better.

A Patient's Guide to Managing a Short Bowel by Carol Rees Parrish, MS, RD.

To learn more about the signs of dehydration and rehydration strategies, talk to your doctor and sign up to receive a copy of A Patient's Guide to Managing a Short Bowel by Carol Rees Parrish, MS, RD.

Oral rehydration solution (ORS) therapy

Norma, a patient living with SBS

ORS, or Oral Rehydration Solution Therapy

ORS is a simple, yet specific, solution of salt, carbohydrate (sugar) and water that is used to help aid in dehydration due to diarrhea. The special ratio of ingredients enhances absorption of fluid across the small bowel wall. Therefore, ORS will be absorbed even in the setting of diarrhea.

A Patient's Guide to Managing a Short Bowel by Carol Rees Parrish, MS, RD.

Talk to your doctor to see if ORS is a good hydration option for you. And to learn more about ORS and for several homemade recipes, sign up to receive a copy of A Patient's Guide to Managing a Short Bowel by Carol Rees Parrish, MS, RD.

The Vitamins and Micronutrients You Need

Depending on which part of your bowel you’re missing, your body might have a hard time absorbing certain vitamins and minerals. Therefore, your doctor might prescribe you a specific mix of vitamin and/or mineral supplements to help enhance your nutrition strategy. These could be vitamins you can purchase over the counter or even prescription intravenous vitamin therapy. Your doctor or dietitian might also suggest specific foods to eat that can help you absorb more of the nutrients you need. But before changing your diet or supplements, remember to always talk to your doctor.

A short bowel syndrome (SBS) patient, Kevin

“I've been prescribed supplements BY MY DOCTOR to help me meet my nutritional needs on a day-to-day basis.”

- Kevin, SBS Patient

SBS patient taking vitamins and micronutrients

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