Children with short bowel syndrome depend on parenteral nutrition, which carries significant risks. Short bowel syndrome patients show reduced gut microbial diversity, increased inflammation-associated bacteria, and fewer beneficial bacteria. This is the first systematic review and meta-analysis examining the gut microbiome in children with short bowel syndrome. The review demonstrated significantly lower bacterial diversity and richness in children with short bowel syndrome, regardless of achievement of intestinal autonomy. Diversity and richness were greater in children who achieved intestinal autonomy than those on parenteral nutrition, though not statistically significant. Larger studies adjusting for confounding factors may identify future therapeutic strategies.
© 2025. The Author(s).