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- Title
Short bowel syndrome in infants: the critical role of luminal nutrients in a management program.
- Authors
Roy, Claude C.; Groleau, Véronique; Bouthillier, Lise; Pineault, Marjolain; Thibault, Maxime; Marchand, Valérie
- Abstract
Short bowel syndrome develops when the remnant mass of functioning enterocytes following massive resections cannot support growth or maintain fluid-electrolyte balance and requires parenteral nutrition. Resection itself stimulates the intestine's inherent ability to adapt morphologically and functionally. The capacity to change is very much related to the high turnover rate of enterocytes and is mediated by several signals; these signals are mediated in large part by enteral nutrition. Early initiation of enteral feeding, close clinical monitoring, and ongoing assessment of intestinal adaptation are key to the prevention of irreversible intestinal failure. The length of the functional small bowel remnant is the most important variable affecting outcome. The major objective of intestinal rehabilitation programs is to achieve early oral nutritional autonomy while maintaining normal growth and nutrition status and minimizing total parenteral nutrition related comorbidities such as chronic progressive liver disease. Remarkable progress has been made in terms of survivability and quality of life, especially in the context of coordinated multidisciplinary programs, but much work remains to be done.
- Subjects
SMALL intestine surgery; DIGESTION; ENTERAL feeding; INFANT nutrition; INTESTINAL absorption; LIPIDS; NUTRITIONAL requirements; OMEGA-3 fatty acids; PARENTERAL feeding; SHORT bowel syndrome; CHILDREN
- Publication
Applied Physiology, Nutrition & Metabolism, 2014, Vol 39, Issue 7, p745
- ISSN
1715-5312
- Publication type
Article
- DOI
10.1139/apnm-2013-0211