Table 4.

Factors Affecting Medication Absorption in the Patient With Short Bowel Syndrome²³

The change to the total surface area, permeability, and integrity of the intestinal epithelia

The change in orocecal transit time

The impact on dissolution and release of the drug from the formulation

Loss of the specific absorptive area in the bowel where the medication is routinely absorbed

Loss of specific enzymes or epithelial transport proteins needed to activate the drug

The location of the bowel that acts as the site of action for the medication

The health of the remaining bowel

The magnitude of intestinal adaptation

Other conditions that alter intestinal architecture and lead to impaired absorption (eg, small bowel bacterial overgrowth)