Concise review on short bowel syndrome: Etiology, pathophysiology, and management

Table 3 Dietary management in patients with colon vs without colon

Surgical operation	Dietary management
End-jejunostomy without colon	(1) Complex carbohydrates are preferred over simple carbohydrates to reduce stoma output; (2) Can tolerate a higher fat diet (30%-40%) than patients with colon continuity; (3) Long-chain triglycerides are favored over MCT because with such anatomy, MCT decreases protein and carbohydrate absorption; (4) Soluble fibers may be administered; and (5) Magnesium (as it is normally absorbed in the distal small intestine or colon), Vitamin B12 and bile salts[14]
Jejuno-colonic anastomosis with some colon in continuity	(1) Due to colon continuity, colonic bacterial fermentation allows salvage of 1,000 additional calories per day. They can benefit from a diet high in complex carbohydrates[9]; (2) Superior outcomes with diets of lower fat compared to higher fat content[52]; (3) Medium-chain triglycerides improve overall fat absorption compared with a similar diet that has only long-chain triglycerides[53]; (4) Prefer diets with low oxalate and high calcium content to avoid calcium oxalate nephrolithiasis[11]; and (5) Soluble fibers are preferred compared to insoluble fibers. Fibers should be avoided in patients with diarrhea of > 3 L/d[11]
Jejuno-ileocolic anastomosis with full colon

MCT: Medium-chain triglycerides.