Nutrition Management of Adult Short Bowel Syndrome

Authors

  • Chompunuch Manathamsombat Division of Clinical Nutrition, Department of Internal Medicine, Phramongkutklao Hospital
  • Samitti Chotsriluecha Division of Clinical Nutrition, Department of Internal Medicine, Pharmongkutklao Hospital
  • Sirikarn Tejavanija Division of Clinical Nutrition, Department of Internal Medicine, Pharmongkutklao Hospital

Keywords:

short bowel syndrome, parenteral nutrition, intestinal failure

Abstract

Short bowel syndrome (SBS) is the most common form of intestinal failure (IF). The primary mechanism of SBS is malabsorption of  ingested foods, due to a reduction or bypass of the absorptive mucosal surface which result in malnutrition and dehydration. As such, management of SBS depends on gastrointestinal anatomy and physiology which requires a personalized plan of nutrition-related, medical interventions to optimize nutrients, fluid, and electrolyte balance. Nutrition management of SBS is composed of a supply of nutrients by enteral route which helps stimulating gastrointestinal adaptation, parenteral nutrition, fluid and pharmacologic treatment to control loss of water and electrolytes as well as monitoring for possible complications. Moreover, psychological support is also important.

References

Pironi L, Arends J, Bozzetti F, Cuerda C, Gillanders L, Jeppesen PB, et al. ESPEN guidelines on chronic intestinal failure in adults. Clin nutr 2016;35(2):247-307.

Pironi L, Arends J, Baxter J, Bozzetti F, Pelaez RB, Cuerda C, et al. ESPEN endorsed recommendations. Definition and classification of intestinal failure in adults. Clin nutr 2015;34(2):171-80.

Buchman AL. Etiology and Initial Management of Short Bowel Syndrome. Gastroenterology 2006;130(2):S5-S15.

Limketkai BN, Orandi BJ, Luo X, Segev DL, Colombel J-F. Mortality and rates of graft rejection or failure following intestinal transplantation in patients with vs without Crohn's disease. Clin Gastroenterol Hepatol 2016;14(11):1574-81.

Pironi L, Hebuterne X, Van Gossum A, Messing B, Lyszkowska M, Colomb V, et al. Candidates for intestinal transplantation: a multicenter survey in Europe. Am J Gastroenterol 2006;101(7):1633-43.

Berkeley N. Linmketkai, Ryan T. Hurt, Palmer LB. The ASPEN Adult Nutrition Support Core Curriculum. Short Bowel Syndrome. 3rd ed. Silver Spring: American Society for Parenteral and Enteral Nutrition; 2017. p. 587-601.

Helander HF, Fandriks L. Surface area of the digestive tract - revisited. Scand J Gastroenterol 2014;49(6):681-9.

Jeejeebhoy KN. Short bowel syndrome: a nutritional and medical approach. CMAJ 2002;166(10):1297-302.

Keller J, Panter H, Layer P. Management of the short bowel syndrome after extensive small bowel resection. Best Pract Res Clin Gastroenterol 2004;18(5):977-92.

Tappenden KA. Pathophysiology of short bowel syndrome: considerations of resected and residual anatomy. JPEN J Parenter Enteral Nutr 2014;38(1 Suppl):14s-22s.

Welters CFM, Dejong CHC, Deutz NEP, Heineman E. Intestinal adaptation in short bowel syndrome. ANZ J Surg 2002;72(3):229-36.

Weale AR, Edwards AG, Bailey M, Lear PA. Intestinal adaptation after massive intestinal resection. Postgrad Med J 2005;81(953):178-84.

Scott RB, Kirk D, MacNaughton WK, Meddings JB. GLP-2 augments the adaptive response to massive intestinal resection in rat. Am J Physiol 1998;275(5):G911-21.

Bechtold ML, McClave SA, Palmer LB, Nguyen DL, Urben LM, Martindale RG, et al. The pharmacologic treatment of short bowel syndrome: new tricks and novel agents. Curr Gastroenterol Rep 2014;16(7):392.

Jeppesen PB, Pertkiewicz M, Messing B, Iyer K, Seidner DL, O'Keefe S J, et al. Teduglutide reduces need for parenteral support among patients with short bowel syndrome with intestinal failure. Gastroenterology 2012;143(6):1473-81.e3.

Gregor M, Menge H, Stossel R, Riecken EO. Effect of monoclonal antibodies to enteroglucagon on ileal adaptation after proximal small bowel resection. Gut 1987;28 Suppl:9-14.

Lai HS, Chen WJ, Chen KM, Lee YN. Effects of monomeric and polymeric diets on small intestine following massive resection. Taiwan Yi Xue Hui Za Zhi 1989;88(10):982-8.

DiBaise JK, Young RJ, Vanderhoof JA. Intestinal rehabilitation and the short bowel syndrome: part 2. Am J Gastroenterol 2004;99(9):1823-32.

Goral K, Matras P, Skrzypek M. Nutritional management of short bowel syndrome in adult patients. EJMT 2018;4:21.

Parrish CR, DiBaise JK. Managing the Adult Patient With Short Bowel Syndrome. Gastroenterol Hepatol 2017;13(10):600-8.

Messing B, Pigot F, Rongier M, Morin MC, Ndeindoum U, Rambaud JC. Intestinal absorption of free oral hyperalimentation in the very short bowel syndrome. Gastroenterology 1991;100(6):1502-8.

Joly F, Dray X, Corcos O, Barbot L, Kapel N, Messing B. Tube feeding improves intestinal absorption in short bowel syndrome patients. Gastroenterology 2009;136(3):824-31.

Fragkos KC, Forbes A. Citrulline as a marker of intestinal function and absorption in clinical settings: A systematic review and meta-analysis. United European gastroenterol J 2018;6(2):181-91.

Matarese LE, O'Keefe SJ, Kandil HM, Bond G, Costa G, Abu-Elmagd K. Short bowel syndrome: clinical guidelines for nutrition management. Nutr Clin Pract 2005;20(5):493-502.

Atia A, Girard-Pipau F, Hebuterne X, Spies WG, Guardiola A, Ahn CW, et al. Macronutrient absorption characteristics in humans with short bowel syndrome and jejunocolonic anastomosis: starch is the most important carbohydrate substrate, although pectin supplementation may modestly enhance short chain fatty acid production and fluid absorption. JPEN J Parenter Enteral Nutr 2011;35(2):229-40.

Barrett JS, Gearry RB, Muir JG, Irving PM, Rose R, Rosella O, et al. Dietary poorly absorbed, short-chain carbohydrates increase delivery of water and fermentable substrates to the proximal colon. Aliment Pharmacol Ther 2010;31(8):874-82.

Nordgaard I, Hansen BS, Mortensen PB. Importance of colonic support for energy absorption as small-bowel failure proceeds. Am J Clin Nutr 1996;64(2):222-31.

Byrne TA, Veglia L, Camelio M, Cox S, Anderson S, Wilson J, et al. Clinical observations: Beyond the prescription: optimizing the diet of patients with short bowel syndrome. Nutr Clin Pract 2000;15(6):306-11.

Sundaram A, Koutkia P, Apovian CM. Nutritional management of short bowel syndrome in adults. J Clin Gastroenterol 2002;34(3):207-20.

Nightingale J, Woodward JM, Small B, Nutrition Committee of the British Society of G. Guidelines for management of patients with a short bowel. Gut 2006;55 Suppl 4(Suppl 4):iv1-iv12.

Buchman AL, Scolapio J, Fryer J. AGA technical review on short bowel syndrome and intestinal transplantation. Gastroenterology 2003;124(4):1111-34.

Downloads

Published

2020-12-30

How to Cite

Manathamsombat, C. ., Chotsriluecha, S. ., & Tejavanija, S. . (2020). Nutrition Management of Adult Short Bowel Syndrome. Thai JPEN วารสารโภชนบำบัด, 28(2), 89–101. retrieved from https://he02.tci-thaijo.org/index.php/ThaiJPEN/article/view/248439

Issue

Vol. 28 No. 2 (2020): July-December 2020

Section

Review article

License

The content and information in the articles published in Thai JPEN วารสารโภชนบำบัด, are the opinions and responsibility of the authors directly. The editorial team is not obliged to agree or take any responsibility.

All articles, content, figures, etc. that have been published in Thai JPEN วารสารโภชนบำบัด are the copyright of Thai JPEN วารสารโภชนบำบัด. If any person or organization require distribution of all or any part of them, please send the request for the written permission from Thai JPEN วารสารโภชนบำบัด  only.