Understanding Intestinal Adaptation
After Surgery: The Absorption Crisis
Your intestines are where the magic happens - where your body breaks down food and absorbs nutrients into your bloodstream. The small intestine has villi - tiny finger-like projections that increase surface area for absorption. They're incredibly efficient.
When you have surgery to remove significant portions of your small intestine - whether due to Crohn's disease, tumor removal, trauma, or vascular issues - you suddenly lose massive absorption capacity. The remaining intestine tries to compensate through a process called intestinal adaptation, where the remaining villi grow taller and broader. But adaptation has limits.
Without enough absorbing surface area, you can't get adequate calories, protein, vitamins, and minerals from food, no matter how much you eat. This leads to parenteral nutrition (PN) - essentially feeding yourself intravenously through a central line.
"Parenteral nutrition is life-saving but comes with serious risks: infections, blood clots, and liver disease from long-term use."
This is where teduglutide and GLP-2 analogs come in - they're not trying to replace missing intestine, they're trying to maximize what you have left. By stimulating growth of the remaining intestinal tissue, they help you absorb more nutrients from food and reduce or eliminate PN dependence.