Intestinal Failure

Common causes are short bowel syndrome (when a large part of the small intestine has been removed or does not work, for example after surgery for Crohn's disease, blocked blood supply, or twisting of the bowel), motility disorders where the gut muscles do not move food along properly, extensive disease or damage of the gut lining, and long-term blockage or fistulas of the bowel. In children, causes include birth defects of the bowel.

Chronic intestinal failure is rare, but acute intestinal failure after major surgery or illness is seen more often in hospitals. Long-term cases are usually looked after in specialised centres.

If you wish to fast in Ramadan, discuss it with your specialist team well in advance. Fasting is often not safe for people who depend on fluids or nutrition from a vein or who lose fluid easily, and your doctor will advise you on what is right for you.

Doctors look at how much you eat and drink, the amount and type of stool or stoma output, your weight, and blood tests for minerals, vitamins, kidney and liver function. They also work out the cause using imaging such as CT, MR enterography (an MRI of the small bowel) and sometimes endoscopy, and may measure the remaining length of bowel from operation notes. Tests for how well the gut moves and absorbs may be added. A multidisciplinary team of gastroenterologists, surgeons, dietitians and nurses usually decides the plan.

Your specialist team directs your care. Never change your feeding or fluid plan on your own.

• Follow your nutrition plan and attend all monitoring visits and blood tests

• If you have a feeding line, wash hands before touching it and follow your nurses' training exactly

• Weigh yourself regularly and record fluid in and out, as your team advises

• Keep emergency contact numbers and a care plan with you, and know when to call

• Keep active within your limits to protect muscles and bones

Diet is individual and set by a dietitian. Eating by mouth is encouraged where possible, since it helps the gut adapt.

• Eat small, frequent meals and snacks as advised

• Your dietitian may adjust fluids, salt and sugar, as drinking large amounts of plain water or sugary drinks can sometimes increase losses

• Oral rehydration solutions may be advised in some people

• Vitamin, mineral and trace element supplements are often needed; take only those prescribed

• Do not follow restrictive or fad diets

Medicines are used to slow gut transit, reduce secretions and protect nutrition. Your team decides on the types and the amounts.

• Anti-diarrhoeal medicines to slow the gut

• Acid-reducing medicines to cut down stomach secretions in some people

• Parenteral nutrition or intravenous fluids as prescribed

• Medicines that support gut adaptation in selected people under specialist care

• Treatment of small bowel bacterial overgrowth, if present

Procedures are matched to the cause and to what the remaining bowel can do.

• A central venous catheter or similar line for intravenous feeding

• A feeding tube into the stomach or bowel in suitable people

• Reconnecting a bowel opening or restoring continuity when it is safe

• Surgery to lengthen or reshape the bowel in selected people

• Bowel transplantation in carefully selected people at specialist centres

Care has improved with specialist intestinal rehabilitation programmes that aim to help the remaining gut adapt and reduce dependence on intravenous feeding. Some medicines that support absorption or reduce fluid loss can help selected people. Bowel transplantation is reserved for a small number with serious complications.

Outlook depends on the cause, how much healthy bowel remains, and access to specialist care. Some people recover enough to stop intravenous feeding, particularly when the gut can adapt over months to years. Others need support long term, and with good care many people live active lives at home. Complications, such as line infections, dehydration, and liver or bone problems, are the main risks and are reduced by close monitoring.

• What is the cause of my intestinal failure and is it likely to improve?

• Do I need parenteral nutrition and for how long?

• What signs of infection or dehydration should make me call or come in?

• Which supplements and tests do I need?

• Can I travel, work or fast in Ramadan?

This guide comes from the Saudi Gastroenterology Association (SGA) patient library, prepared by the Approved for publication by SGA; individual clinician review is ongoing. Last reviewed: 2026-04-24. It is for education and does not replace your doctor's advice.