If a patient loses more than what fraction of the small intestine, the prognosis is typically poor?

• A. 1/2
• B. 2/3
• C. 3/4
• D. 5/6

Answer: (B)

Short bowel syndrome is driven by how much small intestine remains to absorb nutrients. The intestine can adapt after resection, increasing its absorptive efficiency, but this compensation has limits. When more than about two-thirds of the small intestine is removed, the remaining segment usually can’t absorb enough fluids, vitamins, minerals, and calories, leading to chronic malnutrition, dehydration, electrolyte imbalances, and reliance on long-term parenteral nutrition. In an average adult with roughly 6 meters of small bowel, losing about 4 meters or more dramatically reduces surface area and absorptive capacity, making prognosis poor. If the loss stays under that threshold, some enteral nutrition is often still possible as adaptation occurs over weeks to months, but beyond it the outlook worsens markedly.