What are the indications for referral to a specialist in the management of short bowel syndrome?

Indications for referral to a specialist in the management and investigations of short bowel syndrome (SBS) include:

• Complex nutritional management needs that cannot be met in primary care, such as the requirement for specialised parenteral nutrition support.
• Complications related to SBS, including severe malabsorption, electrolyte imbalances, or liver dysfunction.
• Need for multidisciplinary assessment involving gastroenterologists, dietitians, and surgeons experienced in SBS.
• Diagnostic uncertainty or the need for advanced investigations beyond the scope of primary care.
• Failure to respond to initial management strategies or worsening clinical status.

Referral should be made to a specialist with appropriate skills and experience, typically a gastroenterologist or a multidisciplinary intestinal failure team, to ensure comprehensive assessment and management.