Will Nutrition and Management Stop Hemorrhagic Bowel Syndrome? A Veterinarian’s Perspective

By William L. Hollis, B.S., D.V.M., Carthage Veterinary Service, Ltd. Professional Swine Management, LLC, IL, USA and published in the Midwest Swine Nutrition Conference 2006.
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Hemorrhagic bowel syndrome is such defined due to the low prevalence and inability to target one specific disease process or organism as the contributor to the syndrome. In order to answer the question of nutrition and management we have to review both nutritional offerings and management practices that have made efforts at changing the incidence of hemorrhagic bowel syndrome. Unfortunately, very little scientific research is available for example, in preparation for this presentation over 106,000 research articles specific to swine disease management and health were searched. Of these thousands of articles only 6 research articles were identified specific to hemorrhagic bowel syndrome or similar disease consequence. The most recent of these is a research article from Barbara Straw which outlined two specific farms and the contributing factors to the disease from a causative agent standpoint. Pig manufacturers and suppliers have continued to evaluate the ability of alternative ingredients to swine diets in an effort to reduce the incidence of hemorrhagic bowel syndrome. Most nutritional products are based on the gut is quickly voided of fecal material and through feed outages or just gut transit time the mycoflora or normal bacteria allowed to overgrow such as more commonly defined in ruminant nutrition.

Efforts at swine nutrition to reduce this syndrome have provided both fiber content outlines and direct fed microbial outlines as a comparison to traditional swine diets. Antidotal data is provided. However, field experiences are still mixed and controlled proven studies are difficult to identify in the published research.

Management practices are an avenue I personally can see direct correlation. Barb Straw in her research evaluated a combination of management practices and environmental influence leading to an increase in the incidence of hemorrhagic bowel syndrome. (Factors associated with death due to hemorrhagic bowel syndrome in two large commercial swine farms, Straw, 1976).

Finally, the bulk of response from my experience can be achieved through predictable behavior and maintaining standard growing environment, square footage, and eating behavior as consistent as possible. Our practice recommendations include management practices specific for square footage, feeder space, good daily pen management, feeder management, and the inclusion of pulsed therapeutics or alternative ingredients when appropriate. The performance comparisons our clients have shared show 1-2% reduction in late finisher mortality by these recommendations. This is highly variable and difficult to standardize.


Hemorrhagic bowel syndrome is defined by Drs. Barbara Straw and Cale Dewey as such: “Hemorrhagic bowel syndrome has taken on more importance and prominence in the last decade. It primarily affects rapidly growing pigs between 4 and 6 months of age (7 to 120 kg). The size and otherwise excellent health of the affected animals make this condition of particular economic importance. There is considerable ambiguity in the clinicopathological definition of HBS. The term “hemorrhagic bowel syndrome” has been applied when finishing swine die suddenly without premonitory evidence of diarrhea or other clinical signs, and on post mortem examination of a recently dead animal, there is marked pallor of the skin and pronounced distention of the abdomen. The small intestine is thin-walled and filled with either clotted or unclotted blood. The large intestine contains tarry fecal material, but lesions suggestive of gastric ulceration, necroproliferative enteritis, salmonellosis, swine dysentery, or other identifiable disease processes are absent.”

Will nutrition and management stop the syndrome? The short answer is yes we have found that we can reduce the incidence of hemorrhagic bowel syndrome with intervention that prohibits the generally accepted cause of the syndrome. In a general sense the gut is either empty or transit time is accelerated leading to volvulus and dilatation of the bowel. Similar argument could be made that overgrowth of the mycoflora lead to destruction of the lining thinning of the bowel and erosion of the vascular integrity.

In order to reduce the incidence of this syndrome gut-fill eating behavior and reduction in mycoflora overgrowth all lead to improvement in survivability. Most important to keep in mind is when mortality occurs an appropriate definition is required to understand if the intervention method you are taking is appropriate. We will only discuss hemorrhagic bowel syndrome in the clearest form which is the thin walled gut lining and possibility of volvulus. We will not include the well defined and well accepted causes of bloody diarrhea such as swine dysentery or Lawsonia intracellularis. We are purely discussing the syndrome of hemorrhagic bowel syndrome as described above.


Hemorrhagic bowel syndrome is not clearly defined within the scientific community due to the inability to recreate consistently the syndrome. The culmination of several things lead to mortality and most producers and veterinarians accept that there are many triggers which can lead to mortality from hemorrhagic bowel in large pigs. First and highest on my list when reviewing both the research and discussing with producers is the inability of a pig to consistently eat a normal diet every day. This trigger will consistently create fighting and binge eating. Combine this with the extreme heat of the summer and binge eating is accelerated even to a short time period throughout the night.

How will we stop this syndrome with nutrition and management? Again, this is antidotal and poorly defined in research. However, I will propose to you that products on the market to reduce the possibility of a gut devoid of fecal matter and also maintain normal growth rates will be successful. I also submit that many of our clients find an appropriate stocking density, well managed environment, acceptable and appropriate feeder space as well as a uniform loadout process all contribute to improvement and prevent the extreme swings of mortality from hemorrhagic bowel syndrome as well.


  • Gut fill: Infrequent meals and large volumes of gut fill predispose the intestine to rotate. (The effect of feeding on the motility of the stomach and small intestine in the pig. Ruckebusch and Bueno.)
  • Dried Distillers Grains: Fiber content and motility changes due to gut fill offer some promise of benefit. 10% or 200 lbs/ton in swine diets throughout are quite common today. Ethanol increases in production will make this standard. Feeding dried distiller grains greater than 10% leads to a decrease in carcass yield due to gut fill/offal as well as some reports of changes in fat color and consistency due to vegetable oil content.
  • , Calsporin®– Calpis Co. Ltd., BioPlus 2B - Chr. Hansen BioMoss –Dr. Jim Pettigrew is researching this product. (direct fed microbials): Peer reviewed research is desperately needed in this area. Dr Jim Pettigrew has shown performance benefit and highly recommends the practice. Producer skepticism and a lack of economic performance data in the research community have left these products as small consideration for most of our clients. Nursery or starter pig rations are not.
  • Mycotoxins: Mycotoxins have been implicated as a cause of HBS in early literature (Biehl, 1977) 1977 professional journal. However, my opinion is such that the feed refusal created the environment leading to HBS, rather than a direct causative agent. In the research case cited above, the same feed known to contain mycotoxins fed to another population of pigs did not create the same outbreak.
  • Fiber source (soy hulls, wheat mids)


  • Binge eating/gut-fill (Table 1)
  • Feed outages: Dr. Mike Bramm has created a training program for growers and feeding barn managers to follow, which is designed to prevent feed outages. Foremost in this program is the need to manage feed bins properly. His study found that feed outages occurring even once for 24 hours during a growing period cost the population over $1.00 per pig on a 1,000 head population.
  • Stocking density: Management of stocking density can be a contentions issue with producers. Some genetics can handle less square footage than others. My recommendation is to follow the controlled studies of your genetic supplier, and base your judgment on market weight maximums not average weight. Most of our clients feed PIC pigs correctly. The current PIC recommendation is 7.3 square feet for 280 pound slaughter weight (320 lb. maximum weight). We recommend 7.5 square feet initial stocking which allows for some minimal sort off and losses. These recommendations are for the PIC C22 female crossed with either the 327, 337, or 380 boar lines. (Pig Improvement Company; Franklin by: Dr Noel Williams, PhD).
  • Starting pigs on feed
  • Sorting to slaughter


To accept the producers prospective of hemorrhagic bowel syndrome we also have to define the impact of mortality with economics. I have created 2 tables to bring to light the cost of mortality at standard figures of cost of production. These tables are simply to reference the impact as we look at antidotal data on mortalities and prevalence in the industry. If we accept that 2% of late finisher mortality as a result of hemorrhagic bowel syndrome and those pigs will be 200 pounds we are then looking at a cost per 1,000 head finisher of $1798 or nearly $2 per pig. Please use this reference chart as you review production for swine producers and help them to understand the need to take intervention seriously.

Most of my clients see hemorrhagic bowel syndrome but not an economic threat to their herd. I try to encourage evaluation of the higher level of performance as well as decrease mortality as we review intervention measures. Pigs lost from hemorrhagic bowel syndrome are most commonly perfectly otherwise healthy pigs with a little performance loss and in many cases the larger pigs in the population. For that reason most clients are not inclined to evaluate intervention strategies that run the risk of a reduction in daily gain performance. I have also included with this report referenced to Mike Bramms performance data on feed outages. This table shows the incidents of feed outage occurrence and the cost to the producer. For that reason I highly recommend double bins and tandem and a training process where by producers know how to ensure that feed is always available onsite.


Straw B, Dewey C, Kober J, Henry C. Factors associated with death due to hemorrhagic bowel syndrome in two large commercial swine farms. J Swine health Prod. 2002;10(2):75-79.
Biehl L. Hemorrhagic bowel syndrome in Swine. Prof Journal. 1977


Schultz RA, Daniels GN. Use of BMD to control hemorrhagic bowel syndrome in swine. Vet Med. 1984:79;253-256
Smith WJ, Shanks, PL., Intestinal haemorrhage syndrome. Vet Rec. 1971;89:55-56.
Christensen G, Sorensen V, Mousing J. Diseases of the respiratory system, In: Straw BE, D’Allaire S. Mengeling Wl, Taylor DJ, eds. Diseases of Swine, 8th ed. Ames, Iowa: Iowa State University Press; 1999:913-940.
Ruckebusch Y, Bueno L. The effect of feeding on the motility of the stomach and small intestine in the pig. Br J Nutr. 1976;35:397-405.
Ewbank R, Bryant MJ. Aggressive behavior amongst groups of domesticated pigs kept a various stocking rates. Anim Behav. 1972;20:21-28.

Non Refereed

Schultz RA, Daniels GN. Use of BMD to control hemorrhagic bowel syndrome in swine. Proc 8th IPVS Cong. 1984;363.
Lomax L. Hemorrhagic bowel syndrome. Proc AASP. Kansas City, Missouri. 1979;1-9.

Further Information

To view the tables for this article, click here. (pdf)

To view the full list of articles from the Midwest Swine Nutrition Conference 2006, click here

September 2006
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