31 results on '"Short bowel syndrome"'
Search Results
2. Short Bowel Syndrome in neonates and early infancy.
- Author
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Dogra, Shivani, Peters, Nitin James, and Samujh, Ram
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SHORT bowel syndrome , *SMALL intestine , *ELECTROLYTES , *MUSIC teachers , *NUTRITION - Abstract
Short bowel syndrome (SBS) is the commonest cause of intestinal failure in neonates. SBS results from widespread damage to the small intestine, leading to loss of functional capacity of this organ. This is generally secondary to conditions like necrotizing enterocolitis, gastroschisis, intestinal atresia, and midgut volvulus. The small bowel usually adapts to this damage in due course of time. The clinician's role usually entails the management of parenteral nutrition and the fluid and electrolyte balance to tide over this phase. The management should be initiated as soon as the diagnosis is suspected, especially postsurgical resection of the bowel. This should comprise enteral nutrition, with proactive monitoring and supplementation of electrolytes and micronutrients. Intestinal lengthening procedures like the Serial transverse enteroplasty (STEP), and Longitudinal intestinal lengthening and tailoring (LILT) may be considered in infants, where medical therapy fails to correct the pathology. The intricate nature of the condition warrants a multi-disciplinary approach, involving clinicians, intensivists, and surgeons, which ensures the best neonatal outcomes, in terms of the survival rates in these babies. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
3. Use of Teduglutide in Children With Intestinal Failure: A Systematic Review
- Author
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Francesca Gigola, Maria Chiara Cianci, Roberto Cirocchi, Maria Chiara Ranucci, Marco Del Riccio, Riccardo Coletta, and Antonino Morabito
- Subjects
glucagon-like peptide 2 ,rare disease ,parenteral nutrition ,short bowel syndrome ,malabsorption ,intestinal adaptation ,Nutrition. Foods and food supply ,TX341-641 - Abstract
Background and ObjectivesShort-bowel syndrome (SBS) results from the loss of a significant portion of the small intestine leading to a state of malabsorption. After an intestinal loss, there is a process of adaptation involving the Glucagon-Like Peptide-2 (GLP-2), an enteroendocrine peptide also involved in nutrient absorption. Teduglutide is a recombinant analog of GLP-2 approved in 2016 to treat selected SBS pediatric patients who are dependent on parenteral support. The present systematic review aims to evaluate the efficacy of Teduglutide in pediatric patients with SBS in reducing the need for parenteral nutrition (PN).Materials and MethodsWe performed a literature search on MEDLINE and Embase to include articles up to November 2021. We included articles that involved using Teduglutide in the SBS pediatric population to define its efficacy in reducing the need for PN. The key words used were GLP-2, teduglutide, child.ResultsFourteen studies completely fulfilled the inclusion criteria. Two hundred 23 patients were treated with Teduglutide, and the median duration of treatment was 45 weeks (IQR: 36–52.5 weeks). One-hundred and fifty-two patients were treated with 0.05 mg/Kg/d of subcutaneous Teduglutide, 38 received 0.025 mg/Kg/d and 8 received either 0.125 mg/Kg/d or 0.20 mg/Kg/d. A total of 36 patients achieved enteral autonomy (EA) after a median of 24 weeks of treatment (IQR: 24–48 weeks) and 149 patients showed a reduction in PN needs in terms of volume, calories, or hours per day. Eleven studies reported complications: gastrointestinal were the most common, with 89 cases reported in treated patients and 11 in non-treated patients.ConclusionTeduglutide appears safe and effective in reducing PN requirements and improving EA in the pediatric population. However, more studies are needed to understand its efficacy in the long term and after discontinuation and possible complications.Systematic Review Registration[https://www.crd.york.ac.uk/prospero/], identifier [CRD42022301593].
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- 2022
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4. Adult patient living 32 years with postduodenal remnant small bowel of only 35 cm in jejunocolic anastomosis type II weaned off parenteral nutrition. A case report.
- Author
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El-Helou, Etienne, Alimoradi, Mersad, Sabra, Hassan, Naccour, Jessica, Haddad, Marwan M., and Chahine, Georges
- Abstract
• The small intestine is an essential constituent of the digestive system and plays a major role in the absorption of nutrients. • Acute mesenteric ischemia remains an emergency case. • Failure to adapt and the inadequate nutritional supply result in Short bowel syndrome. • A minimal indispensable length is required for nutritional autonomy. • Parenteral Nutrition still presents a pertinent problem of complications, charges and impairment in quality of life. The small bowel is an essential organ for maintaining adequate nutrition. Decrease in length could be associated with malnutrition and may require that the patient receives parenteral nutritional support. We report a case of a 59-year-old man who survived32 years with a short bowel of 35 cm length without any parenteral nutrition. A 59-year-old gentleman, with a history of hypercoagulable state, presented for severe abdominal pain and obstipation of one day's duration. Upon presentation, the patient was hemodynamically unstable, with abdominal guarding and tenderness upon physical examination. Laboratory studies showed metabolic acidosis with leukocytosis and electrolyte disturbances, and an abdominal CT scan showed thickening of the sigmoid and multiple air-fluid levels. The patient was operated urgently for suspicion of mesenteric ischemia, however, he was found intraoperatively to have a very short dilated small bowel with jejunotransverse anastomosis. The necessity for surgical resection of the small bowel can arise for a sum of reasons. However, the removal of a big amount of small bowel may not be adaptive and appropriate digestion will no more be possible. In the aftermath of the resection, patients require parenteral nutrition for a certain period after which they may switch to enteral and oral nutrition, and subsequently intestinal adaptation by thickening and growth of the remaining intestinal villi. Patients with a short bowel, particularly those surgically removed, can survive even with a very short remaining bowel length, as a result of intestinal adaptation, nutrition enhancement, and elimination of parenteral nutrition. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
5. Repeated Metabolic Balance Studies in Patients With Short Bowel Syndrome.
- Author
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Sun, Haifeng, Eliasson, Johanna, Fuglsang, Kristian A., Hvistendahl, Mark, Naimi, Rahim M., and Jeppesen, Palle B.
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SHORT bowel syndrome ,INTESTINAL absorption ,COLON (Anatomy) ,RETROSPECTIVE studies ,PHYSIOLOGICAL adaptation ,PARENTERAL feeding ,INTESTINES - Abstract
Background: Weaning from parenteral support is considered indirect evidence of intestinal adaptation in patients with short bowel syndrome (SBS), but direct evidence is lacking. The objective of this study was to examine if intestinal adaptation could be demonstrated as increase in intestinal absorption of energy and wet weight over time measured by repeated metabolic balance studies (MBSs) and to examine whether adaptation was determined by the anatomy of the remnant bowel.Methods: We retrospectively analyzed data from 48 repeated MBSs performed in 13 adult patients with SBS. Results were presented graphically and interpreted. The interpatient and intrapatient heterogeneity was compared based on anatomy of the remnant bowel.Results: The number of repeated MBSs ranged from 2 to 7, and time between last intestinal resection and MBS from 5 months to 18.1 years. In 6 patients, the first MBS was performed within 2 years after last resection, but only 1 patient had repeated MBSs within this period. Nine patients had an end jejunoileostomy, and 4 patients had a jejuno-colonic or ileo-colonic anastomosis. None of the patients had jejunoileal anastomosis with a preserved ileocecal valve. Interpatient and intrapatient heterogeneity of wet weight and energy absorption was larger in patients without colon in continuity. The wet weight and energy absorption data showed no tendency toward intestinal adaptation in any anatomical group.Conclusion: We observed no signs of late-phase intestinal adaptation in this selected group of patients with SBS. Future prospective MBSs are needed to understand the time course and magnitude of intestinal adaptation. [ABSTRACT FROM AUTHOR]- Published
- 2020
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6. Short Bowel Syndrome: A Paradigm for Intestinal Adaptation to Nutrition?
- Author
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Le Beyec, Johanne, Billiauws, Lore, Bado, André, Joly, Francisca, and Le Gall, Maude
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PHYSIOLOGICAL adaptation , *HUMAN microbiota , *DIETARY supplements , *NUTRITION , *PARENTERAL feeding , *HYPERPHAGIA , *SHORT bowel syndrome , *GLUCAGON-like peptides - Abstract
Short bowel syndrome (SBS) is a rare disease that results from extensive resection of the intestine. When the remaining absorption surface of the intestine cannot absorb enough macronutrients, micronutrients, and water, SBS results in intestinal failure (IF). Patients with SBS who suffer from IF require parenteral nutrition for survival, but long-term parenteral nutrition may lead to complications such as catheter sepsis and metabolic diseases. Spontaneous intestinal adaptation occurs weeks to months after resection, resulting in hyperplasia of the remnant gut, modification of gut hormone levels, dysbiosis, and hyperphagia. Oral nutrition and presence of the colon are two major positive drivers for this adaptation. This review aims to summarize the current knowledge of the mechanisms underlying spontaneous intestinal adaptation, particularly in response to modifications of luminal content, including nutrients. In the future, dietary manipulations could be used to treat SBS. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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7. Nutrition in Necrotizing Enterocolitis and Following Intestinal Resection
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Jocelyn Ou, Cathleen M. Courtney, Allie E. Steinberger, Maria E. Tecos, and Brad W. Warner
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necrotizing enterocolitis ,prematurity ,intestinal resection ,short bowel syndrome ,intestinal adaptation ,microbiome ,parenteral nutrition ,hormones ,breast milk ,Nutrition. Foods and food supply ,TX341-641 - Abstract
This review aims to discuss the role of nutrition and feeding practices in necrotizing enterocolitis (NEC), NEC prevention, and its complications, including surgical treatment. A thorough PubMed search was performed with a focus on meta-analyses and randomized controlled trials when available. There are several variables in nutrition and the feeding of preterm infants with the intention of preventing necrotizing enterocolitis (NEC). Starting feeds later rather than earlier, advancing feeds slowly and continuous feeds have not been shown to prevent NEC and breast milk remains the only effective prevention strategy. The lack of medical treatment options for NEC often leads to disease progression requiring surgical resection. Following resection, intestinal adaptation occurs, during which villi lengthen and crypts deepen to increase the functional capacity of remaining bowel. The effect of macronutrients on intestinal adaptation has been extensively studied in animal models. Clinically, the length and portion of intestine that is resected may lead to patients requiring parenteral nutrition, which is also reviewed here. There remain significant gaps in knowledge surrounding many of the nutritional aspects of NEC and more research is needed to determine optimal feeding approaches to prevent NEC, particularly in infants younger than 28 weeks and
- Published
- 2020
- Full Text
- View/download PDF
8. Medical and surgical management of short bowel syndrome.
- Author
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Billiauws, L., Maggiori, L., Joly, F., and Panis, Y.
- Abstract
Summary Short bowel syndrome (SBS) is a rare disease, resulting from extensive resection of the small intestine. Depending on the severity of malabsorption, it will lead to intestinal failure, defined as the reduction of gut function below the minimum necessary for the absorption of macronutrients and/or water and electrolytes, resulting in a situation where intravenous supplementation is required. The risk of developing intestinal failure is related to the remaining length of small intestine and the anatomy of the remnant bowel. SBS incidence has been estimated to range from 5 to 10 patients per year per million population. The main consequence of SBS is a marked reduction of intestinal absorption surface and its main complication is undernutrition and hydro-electrolytic abnormalities. Parenteral nutrition (PN), the major treatment of intestinal failure, has long-term complications. In case of PN dependency, treatment with trophic factors can be proposed. Glucagon-like peptide-2 (GLP-2) analogs allow significant reduction of PN dependency and improve quality of life. Rehabilitative surgery should always be proposed, with the primary goal of restoring digestive continuity. Sometimes, an additional surgical procedure, such as an antiperistaltic reversal of a small bowel segment, is performed when restoring digestive continuity in patients with insufficient length of remnant small intestine to enhance the possibility of PN withdrawal. Intestinal transplantation is proposed as a last resort. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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9. Ghrelin stimulates intestinal adaptation following massive small bowel resection in parenterally fed rats.
- Author
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Onishi, Shun, Kaji, Tatsuru, Yamada, Waka, Nakame, Kazuhiko, Machigashira, Seiro, Kawano, Masato, Yano, Keisuke, Harumatsu, Toshio, Yamada, Koji, Masuya, Ryuta, Kawano, Takafumi, Mukai, Motoi, Hamada, Taiji, Souda, Masakazu, Yoshioka, Takako, Tanimoto, Akihide, and Ieiri, Satoshi
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GHRELIN , *SOMATOTROPIN , *GROWTH factors , *SHORT bowel syndrome , *PARENTERAL feeding - Abstract
Background Since short bowel syndrome (SBS) patients face life-threatening conditions, the development of therapeutic strategies to induce intestinal adaptation has been investigated. Ghrelin, a ligand of growth hormone (GH) secretagogue-receptor that stimulates the release of GH and insulin like growth factor-1 (IGF-1), has several pleiotropic effects. We investigated whether ghrelin induces intestinal adaptation in parenterally fed rats with SBS. Methods Sprague-Dawley rats underwent venous catheterization and were divided into 3 groups: those receiving 90% small bowel resection while leaving the proximal jejunum and distal ileum (90% SBR) with TPN (SBS/TPN group), those receiving 90% SBR with TPN + ghrelin (SBS/TPN/ghrelin group), and those receiving sham operation and fed chow (sham group). Ghrelin was administered intravenously at 10 μg/kg/day. On Day 13, the rats were euthanized and the small intestine harvested, and the histology and crypt cell proliferation rates (CCPR), apoptosis, and nutrient transporter protein levels were analyzed and the plasma hormones were measured. Results The villus height and crypt depth of the ileum in the SBS/TPN/ghrelin group were significantly higher than in the SBS/TPN group. The CCPR of the jejunum and the ileum significantly increased by the administration of ghrelin; however, the apoptosis rates did not significantly differ between the SBS/TPN and SBS/TPN/ghrelin groups. Significant differences did not exist in the plasma IGF-1 and nutrient transporter protein levels among three groups. Conclusions The intravenous administration of ghrelin stimulated the morphological intestinal adaptation of the ileum to a greater degree than the jejunum due to the direct effect of ghrelin. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
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10. Etiology and prognosis of pediatric short bowel syndrome.
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Mutanen, Annika and Wales, Paul W.
- Abstract
Pediatric intestinal failure is a complex and devastating condition defined as the inability of the intestine to absorb an adequate amount of fluid and nutrients to sustain life. The primary goal of intestinal failure treatment is to achieve enteral autonomy with a customized treatment plan. Although recent improvements in intestinal failure patient care have led to significant improvements in the morbidity and mortality rate, children with intestinal failure are at risk for multiple complications such as intestinal failure associated liver disease, recurrent septic episodes, central line complications, metabolic bone disease, impaired kidney function, and failure to thrive. In this article, we review the current literature on the etiology and factors affecting prognosis of pediatric IF. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
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11. Adaptación intestinal en el síndrome de intestino corto: ¿qué hay de nuevo?
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Billiauws, Lore, Thomas, Muriel, Le Beyec-Le Bihan, Johanne, and Joly, Francisca
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SHORT bowel syndrome , *INTESTINAL disease treatment , *SURGICAL excision , *PARENTERAL feeding , *PATHOLOGICAL physiology - Abstract
Short bowel syndrome (SBS) is a well-known cause of intestinal failure (IF) (1). SBS occurs after extensive resection of the small bowel (RSB) resulting in a bowel length of less than 150/200 cm. The colon may have been partially or completely removed. SBS patients experience severe water and nutrient malabsorption, so that they are often managed with parenteral nutrition (PN) to supplement their oral intake (2-4). A complete understanding of the pathophysiology of SBS and postoperative adaptations may allow identifying the spontaneous processes that compensate for the reduction in absorptive surface. A better knowledge of these adaptive mechanisms may help to improve the management of patient nutrition, to reduce the need for PN and to prevent D-encephalopathy episodes. This review focuses on the overall adaptations described in adult SBS patients but does not review pediatric cases. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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12. Insulin-Like Growth Factors in Relation to Gastrointestinal Diseases and Parenteral Nutrition
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Ney, Denise M., Bendich, Adrianne, editor, Houston, M. Sue, editor, Holly, Jeffrey M. P., editor, and Feldman, Eva L., editor
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- 2004
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13. Short Bowel Syndrome
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Shakhsheer, Baddr A. and Warner, Brad W.
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- 2019
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14. Adult patient living 32 years with postduodenal remnant small bowel of only 35 cm in jejunocolic anastomosis type II weaned off parenteral nutrition. A case report
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Hassan Sabra, Mersad Alimoradi, Marwan M. Haddad, Georges Chahine, Etienne El-Helou, and Jessica Naccour
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medicine.medical_specialty ,Abdominal pain ,ER, emergency room ,Intestinal adaptation ,Physical examination ,Anastomosis ,Enteral administration ,Article ,IF, intestinal failure ,03 medical and health sciences ,0302 clinical medicine ,Abdominal guarding ,Case report ,medicine ,Bowel length ,SBS, short bowel syndrome ,medicine.diagnostic_test ,BaFT, barium follow-through ,business.industry ,Short bowel syndrome ,medicine.disease ,Small bowel ,Parenteral nutrition ,ICU, intensive care unit ,Surgery ,CT, computed tomography ,Mesenteric ischemia ,030220 oncology & carcinogenesis ,DVT, deep venous thrombosis ,CRP, C-reactive protein ,TSBL, total small bowel length ,ABG, arterial blood gas ,030211 gastroenterology & hepatology ,medicine.symptom ,VS, versus ,business ,IV, intravenous - Abstract
Highlights • The small intestine is an essential constituent of the digestive system and plays a major role in the absorption of nutrients. • Acute mesenteric ischemia remains an emergency case. • Failure to adapt and the inadequate nutritional supply result in Short bowel syndrome. • A minimal indispensable length is required for nutritional autonomy. • Parenteral Nutrition still presents a pertinent problem of complications, charges and impairment in quality of life., Introduction The small bowel is an essential organ for maintaining adequate nutrition. Decrease in length could be associated with malnutrition and may require that the patient receives parenteral nutritional support. We report a case of a 59-year-old man who survived32 years with a short bowel of 35 cm length without any parenteral nutrition. Case presentation A 59-year-old gentleman, with a history of hypercoagulable state, presented for severe abdominal pain and obstipation of one day's duration. Upon presentation, the patient was hemodynamically unstable, with abdominal guarding and tenderness upon physical examination. Laboratory studies showed metabolic acidosis with leukocytosis and electrolyte disturbances, and an abdominal CT scan showed thickening of the sigmoid and multiple air-fluid levels. The patient was operated urgently for suspicion of mesenteric ischemia, however, he was found intraoperatively to have a very short dilated small bowel with jejunotransverse anastomosis. Discussion The necessity for surgical resection of the small bowel can arise for a sum of reasons. However, the removal of a big amount of small bowel may not be adaptive and appropriate digestion will no more be possible. In the aftermath of the resection, patients require parenteral nutrition for a certain period after which they may switch to enteral and oral nutrition, and subsequently intestinal adaptation by thickening and growth of the remaining intestinal villi. Conclusion Patients with a short bowel, particularly those surgically removed, can survive even with a very short remaining bowel length, as a result of intestinal adaptation, nutrition enhancement, and elimination of parenteral nutrition.
- Published
- 2020
15. Short bowel syndrome in infants: the critical role of luminal nutrients in a management program.
- Author
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Roy, Claude C., Groleau, Véronique, Bouthillier, Lise, Pineault, Marjolain, Thibault, Maxime, and Marchand, Valérie
- Subjects
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SMALL intestine surgery , *DIGESTION , *ENTERAL feeding , *INFANT nutrition , *INTESTINAL absorption , *LIPIDS , *NUTRITIONAL requirements , *OMEGA-3 fatty acids , *PARENTERAL feeding , *SHORT bowel syndrome , *CHILDREN - 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. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
16. Nutrition in Necrotizing Enterocolitis and Following Intestinal Resection
- Author
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Cathleen M. Courtney, Brad W. Warner, Allie E. Steinberger, Jocelyn Ou, and Maria E. Tecos
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0301 basic medicine ,intestinal resection ,medicine.medical_specialty ,Parenteral Nutrition ,microbiome ,lcsh:TX341-641 ,Review ,intestinal adaptation ,Breast milk ,short bowel syndrome ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Enterocolitis, Necrotizing ,medicine ,Animals ,Humans ,030212 general & internal medicine ,Intensive care medicine ,Infant Nutritional Physiological Phenomena ,030109 nutrition & dietetics ,Nutrition and Dietetics ,necrotizing enterocolitis ,Medical treatment ,hormones ,Milk, Human ,business.industry ,prematurity ,Infant, Newborn ,Infant ,Short bowel syndrome ,medicine.disease ,Additional research ,digestive system diseases ,Infant Formula ,3. Good health ,Intestines ,Parenteral nutrition ,Milk ,Necrotizing enterocolitis ,breast milk ,Intestinal resection ,business ,lcsh:Nutrition. Foods and food supply ,Infant, Premature ,Food Science - Abstract
This review aims to discuss the role of nutrition and feeding practices in necrotizing enterocolitis (NEC), NEC prevention, and its complications, including surgical treatment. A thorough PubMed search was performed with a focus on meta-analyses and randomized controlled trials when available. There are several variables in nutrition and the feeding of preterm infants with the intention of preventing necrotizing enterocolitis (NEC). Starting feeds later rather than earlier, advancing feeds slowly and continuous feeds have not been shown to prevent NEC and breast milk remains the only effective prevention strategy. The lack of medical treatment options for NEC often leads to disease progression requiring surgical resection. Following resection, intestinal adaptation occurs, during which villi lengthen and crypts deepen to increase the functional capacity of remaining bowel. The effect of macronutrients on intestinal adaptation has been extensively studied in animal models. Clinically, the length and portion of intestine that is resected may lead to patients requiring parenteral nutrition, which is also reviewed here. There remain significant gaps in knowledge surrounding many of the nutritional aspects of NEC and more research is needed to determine optimal feeding approaches to prevent NEC, particularly in infants younger than 28 weeks and
- Published
- 2020
17. Management of short bowel syndrome in infancy.
- Author
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Batra, A. and Beattie, R.M.
- Subjects
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SHORT bowel syndrome , *INFANT diseases , *SURGICAL excision , *ENTEROCOLITIS , *HOMEOSTASIS , *PARENTERAL feeding , *THERAPEUTICS - Abstract
Abstract: Short bowel syndrome (SBS) is a reduction in functioning bowel length which is most often a result of surgical resection. Risk factors in the neonatal period include necrotising enterocolitis, small bowel atresia and gastroschisis. With increasing survival of preterm infants there is an increase in incidence. Management is dependent on the use of parenteral nutrition to maintain fluid and electrolyte homeostasis and promote growth and development with the longer term aim being to promote intestinal adaptation to achieve partial or complete enteral autonomy. In this review we discuss the incidence, aetiology, pathophysiology, medical and surgical treatments and outcome. [Copyright &y& Elsevier]
- Published
- 2013
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18. Plasma citrulline as marker of bowel adaptation in children with short bowel syndrome.
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Diamanti, Antonella, Panetta, Fabio, Gandullia, Paolo, Morini, Francesco, Noto, Cristian, Torre, Giuliano, Lezo, Antonella, Goffredo, Bianca, Daniele, Antonella, and Gambarara, Manuela
- Subjects
- *
SHORT bowel syndrome , *CALORIC content of foods , *DUODENUM , *BIOMARKERS , *JEJUNUM - Abstract
Purpose: The aim of this study is to determine if prospective determinations of citrulline could be predictive of the bowel adaptation in children with short bowel syndrome (SBS). Methods: Between March 2005 and March 2010, we prospectively included 28 SBS patients on parenteral nutrition. The citrulline and the enteral intake determinations were scheduled at the inclusion and at 6-month intervals. We assessed the correlation between citrulline and bowel length as well as enteral caloric intake, longitudinal trend of citrulline and association between patients characteristics according to the course of bowel adaptation. Results: Citrulline significantly correlated with the residual duodenum-jejunum length ( r = 0.22, P = 0.0113) and with enteral intake ( r = 0.20, P = 0.016 and r = 0.48, P = 0.0001). Baseline citrulline at the cutoff >10 μmol/L and a longitudinal increase >25% provided a weak association with bowel adaptation (likelihood ratio (LR), 2.6 and 2.4, respectively), unlike residual small bowel length ≥20 cm and the presence of >50% of the colon (LR, 10 and 6, respectively). Conclusions: Citrulline seems to be a powerful biomarker of the intestinal function, showed by the correlation with the residual duodenum-jejunum length and the enteral absorption, but not of its prospective changes during the bowel adaptation process. Future studies may be necessary to confirm this finding. [ABSTRACT FROM AUTHOR]
- Published
- 2011
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19. Emerging treatment options for short bowel syndrome: potential role of teduglutide.
- Author
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Tee, Cheng T., Wallis, Katharina, and Gabe, Simon M.
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SHORT bowel syndrome ,MEDICAL protocols ,PARENTERAL feeding ,GLUCAGON-like peptides ,INTESTINAL absorption ,IMMUNOLOGICAL adjuvants ,TREATMENT effectiveness ,THERAPEUTICS - Abstract
Introduction: Current medical management of short bowel syndrome (SBS) involves the use of lifelong parenteral nutrition (PN). Glucagon-like peptide-2 (GLP-2), an important intestinotrophic growth factor has been shown to increase intestinal absorption in SBS through augmentation of post-resection intestinal adaptation. This may lead to the reduction of PN dependence in patients with SBS. Areas covered in review: Advancing research of GLP-2 physiology has spurred the growing understanding of the diverse effects of GLP-2. The development of the degradation resistant GLP-2 analog, teduglutide (GattexTM, NPS Pharmaceuticals, Bedminster, NJ), has allowed its exploration as a therapeutic agent in a variety of clinical settings. Recent multicenter, placebocontrolled studies of GLP-2 in SBS patients demonstrate meaningful reductions in PN requirements with good safety profiles. The reparative and immunomodulatory effects of teduglutide may also be beneficial in patients with inflammatory bowel disease (IBD). Safety concerns about possible carcinogenic properties during long-term use require ongoing evaluation. Summary: GLP-2 appears to offer a novel adjuvant treatment modality for SBS. Promise for its use in other clinical settings like IBD has been shown in small pilot studies. [ABSTRACT FROM AUTHOR]
- Published
- 2011
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20. Intestinal failure: A new era in clinical management.
- Author
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Bines, Julie E.
- Subjects
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INTESTINAL disease treatment , *DIGESTION , *MALNUTRITION , *DIET in disease , *DIETETICS , *CLINICAL medicine , *HUMAN ecology , *PHYSIOLOGY - Abstract
Only 50 years ago intestinal failure was considered incompatible with life. Since then, developments in parenteral nutrition, and, more recently, small intestinal transplantation, have provided new therapeutic options with the potential to offer long-term survival with a good quality of life. Current medical and surgical strategies are aimed at enhancing intestinal adaptation, improving absorption to achieve nutritional independence, and minimizing the complications of parenteral nutrition therapy. An integrated, multidisciplinary approach to the management of patients with intestinal failure, closely linked to a transplantation program to facilitate early referral, is recognized as a key factor in optimizing patient outcomes. [ABSTRACT FROM AUTHOR]
- Published
- 2009
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21. Management of intestinal failure.
- Author
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Soondrum, K. and Hinds, R.
- Abstract
Intestinal failure (IF) occurs when the body is unable to sustain its energy and fluid requirements without support, due to loss of functional small bowel. Prolonged IF is seen after large intestinal resection and described as short bowel syndrome (SBS). The hallmark of the management is parental nutrition (PN), which is costly and may be associated with the well-recognized problems of parental nutrition associated liver disease (PNALD) and line related sepsis. Cessation of PN at the earliest possible stage is desirable but for this enteral autonomy has to be achieved first. Intestinal adaptation occurs when the remaining gut goes through morphological changes increasing its absorptive capacity. Factors such as intraluminal nutrients, gastrointestinal secretions and hormones facilitate adaptation. Enteral feeds are a potent stimulant to adaptation, and should be started as soon as the clinical situation permits. Some drugs are thought to increase intestinal adaptation. These include glutamine, growth hormone and glucagon like peptide-2, but there is a paucity of pediatric data to guide their use. In some cases surgical bowel lengthening procedures can be performed to increase the absorptive surface area. An isolated liver transplantation may be required if the liver has sustained irreversible damage but intestinal autonomy seems achievable. When prolonged PN is either unsustainable or associated with unacceptable side effects, small bowel transplantation should be considered as a treatment option. [ABSTRACT FROM AUTHOR]
- Published
- 2006
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22. Acquired causes of intestinal malabsorption
- Author
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F. van der Heide
- Subjects
Parenteral Nutrition ,medicine.medical_specialty ,Malabsorption ,Stool tests ,Intestinal adaptation ,Context (language use) ,CHILDREN ,ENTERAL NUTRITION ,Gastroenterology ,Enteral administration ,Intestinal absorption ,DISEASE ,03 medical and health sciences ,0302 clinical medicine ,Malabsorption Syndromes ,Internal medicine ,medicine ,ABSORPTION ,Humans ,FAILURE ,SHORT-BOWEL SYNDROME ,030212 general & internal medicine ,Micronutrients ,Cholestyramine ,LACTOSE-MALABSORPTION ,business.industry ,Short bowel syndrome ,PARENTERAL-NUTRITION ,Nutritional Requirements ,Intestinal failure ,medicine.disease ,Small intestine ,Diarrhoea ,Parenteral nutrition ,medicine.anatomical_structure ,BACTERIAL OVERGROWTH ,030211 gastroenterology & hepatology ,LIPASE INHIBITOR ,business ,Enteropathies ,medicine.drug - Abstract
This review focuses on the acquired causes, diagnosis, and treatment of intestinal malabsorption. Intestinal absorption is a complex process that depends on many variables, including the digestion of nutrients within the intestinal lumen, the absorptive surface of the small intestine, the membrane transport systems, and the epithelial absorptive enzymes.Acquired causes of malabsorption are classified by focussing on the three phases of digestion and absorption: 1) luminal/digestive phase, 2) mucosal/absorptive phase, and 3) transport phase. Most acquired diseases affect the luminal/digestive phase. These include short bowel syndrome, extensive small bowel inflammation, motility disorders, and deficiencies of digestive enzymes or bile salts. Diagnosis depends on symptoms, physical examination, and blood and stool tests.There is no gold standard for the diagnosis of malabsorption. Further testing should be based on the specific clinical context and the suspected underlying disease. Therapy is directed at nutritional support by enteral or parenteral feeding and screening for and supplementation of deficiencies in vitamins and minerals. Early enteral feeding is important for intestinal adaptation in short bowel syndrome. Medicinal treatment options for diarrhoea in malabsorption include loperamide, codeine, cholestyramine, or antibiotics. (C) 2016 Elsevier Ltd. All rights reserved.
- Published
- 2016
23. Recent Advances in the Management of Pediatric Short Bowel Syndrome: An Integrative Review of the Literature
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Saeman, Melody R. and Piper, Hannah G.
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- 2016
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24. Intestinal adaptation in short bowel syndrome. What is new?
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Billiauws, Lore, Thomas, Muriel, Le-Beyec-Le-Bihan, Johanne, Joly, Francisca, Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Diderot - Paris 7 (UPD7), MICrobiologie de l'ALImentation au Service de la Santé (MICALIS), Institut National de la Recherche Agronomique (INRA)-AgroParisTech, Université Paris Saclay (COmUE), Université Pierre et Marie Curie - Paris 6 (UPMC), and Sorbonne Universités (COMUE)
- Subjects
GLP-2 analog ,[SDV]Life Sciences [q-bio] ,Short bowel syndrome ,Intestinal adaptation ,Adaptación intestinal ,Agonista GLP2 ,Nutrición parenteral ,Intestinal failure ,Fallo intestinal ,Parenteral nutrition ,Síndrome de intestino corto - Abstract
International audience; Short bowel syndrome (SBS) is a well-known cause of intestinal failure (IF) (1). SBS occurs after extensive resection of the small bowel (RSB) resulting in a bowel length of less than 150/200 cm. The colon may have been partially or completely removed. SBS patients experience severe water and nutrient malabsorption, so that they are often managed with parenteral nutrition (PN) to supplement their oral intake (2-4). A complete understanding of the pathophysiology of SBS and postoperative adaptations may allow identifying the spontaneous processes that compensate for the reduction in absorptive surface. A better knowledge of these adaptive mechanisms may help to improve the management of patient nutrition, to reduce the need for PN and to prevent D-encephalopathy episodes. This review focuses on the overall adaptations described in adult SBS patients but does not review pediatric cases. PMID:; El síndrome del intestino corto es la primera causa de fallo intestinal (que requiere suplementación intravenosa de fluidos, electrolitos y/o calorías). La adaptación fisiológica intestinal ocurre uno a dos años después de la resección quirúrgica. Esta adaptación incluye hiperfagia, cambios en la microbiota, cambios morfológicos intestinales (incluida la hiperplasia), adaptaciones hormonales y otros… El colon desempeña un papel importante y permite la recuperación hidroelectrolítica y energética. Es posible mejorar la adaptación fisiológica mediante la optimización de la intervención dietética, restaurando la continuidad y tratando con factores de crecimiento, como el análogo del GLP-2 (glucagon-like peptide-2).
- Published
- 2018
25. Intestinal adaptation in short bowel syndrome. What is new?
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Johanne Le Beyec Le Bihan, Francisca Joly, Lore Billiauws, Muriel Thomas, Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Diderot - Paris 7 (UPD7), MICrobiologie de l'ALImentation au Service de la Santé (MICALIS), Institut National de la Recherche Agronomique (INRA)-AgroParisTech, Université Paris Saclay (COmUE), Université Pierre et Marie Curie - Paris 6 (UPMC), and Sorbonne Universités (COMUE)
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Adult ,Short Bowel Syndrome ,0301 basic medicine ,medicine.medical_specialty ,Malabsorption ,[SDV]Life Sciences [q-bio] ,Medicine (miscellaneous) ,Intestinal adaptation ,Gastroenterology ,03 medical and health sciences ,GLP-2 analog ,Internal medicine ,Intestinal failure ,medicine ,Humans ,2. Zero hunger ,030109 nutrition & dietetics ,Nutrition and Dietetics ,business.industry ,Short bowel syndrome ,medicine.disease ,Parenteral nutrition ,Adaptation, Physiological ,3. Good health ,Intestines ,Extensive resection ,business - Abstract
Short bowel syndrome (SBS) is a well-known cause of intestinal failure (IF) (1). SBS occurs after extensive resection of the small bowel (RSB) resulting in a bowel length of less than 150/200 cm. The colon may have been partially or completely removed. SBS patients experience severe water and nutrient malabsorption, so that they are often managed with parenteral nutrition (PN) to supplement their oral intake (2-4). A complete understanding of the pathophysiology of SBS and postoperative adaptations may allow identifying the spontaneous processes that compensate for the reduction in absorptive surface. A better knowledge of these adaptive mechanisms may help to improve the management of patient nutrition, to reduce the need for PN and to prevent D-encephalopathy episodes. This review focuses on the overall adaptations described in adult SBS patients but does not review pediatric cases. PMID, El síndrome del intestino corto es la primera causa de fallo intestinal (que requiere suplementación intravenosa de fluidos, electrolitos y/o calorías). La adaptación fisiológica intestinal ocurre uno a dos años después de la resección quirúrgica. Esta adaptación incluye hiperfagia, cambios en la microbiota, cambios morfológicos intestinales (incluida la hiperplasia), adaptaciones hormonales y otros… El colon desempeña un papel importante y permite la recuperación hidroelectrolítica y energética. Es posible mejorar la adaptación fisiológica mediante la optimización de la intervención dietética, restaurando la continuidad y tratando con factores de crecimiento, como el análogo del GLP-2 (glucagon-like peptide-2).
- Published
- 2018
26. Síndrome de intestino corto, un caso de readaptación intestinal
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Gabriel del Castillo Calderón and Dianna Ramírez Prada
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Síndrome intestino corto ,medicine.medical_specialty ,Health (social science) ,Normal diet ,Falha intestinal ,Medicine (miscellaneous) ,Intensive care ,medicine ,Falla intestinal ,Intestinal adaptation ,Intensive care medicine ,Omphalocele ,Adaptação intestinal ,business.industry ,Gastroschisis ,Short bowel syndrome ,Intestinal atresia ,Intestinal failure ,medicine.disease ,Surgery ,Parenteral nutrition ,Necrotizing enterocolitis ,Adaptación intestinal ,Síndrome intestino curto ,business - Abstract
Presentación del caso: El objetivo de este artículo es presentar la experiencia exitosa del manejo multidisciplinario de una paciente con síndrome de intestino corto y falla intestinal con evolución a la adaptación intestinal. Se trata de una recién nacida prematura con atresia intestinal tipo IV, con múltiples atresias intestinales, quien evolucionó a la falla intestinal y requirió manejo con soporte nutricional parenteral prolongado, múltiples esquemas antibióticos, probióticos, multivitaminas, nutrición enteral con fórmula elemental, hasta lograr su adaptación intestinal y llevar a una dieta normal. La falla intestinal en estos pacientes es un reto para el equipo de salud, ya que no solo implica el manejo quirúrgico de su condición de base, si no del soporte nutricional, equilibrio hidroelectrolítico, disfunción hepática por colestasis, infecciones asociadas, etcétera.Discusión: El síndrome de intestino corto con evolución a la falla intestinal en niños es una condición, cuya prevalencia va en aumento en el ámbito mundial, gracias a los avances en el cuidadointensivo neonatal, cirugía neonatal y en el soporte nutricional de pacientes con condiciones como gastrosquisis, onfalocele y enterocolitis necrotizante. A pesar de las limitaciones del sistema de salud, es posible ofrecer un tratamiento multidisciplinario e integral para llevarlos hasta la adaptación intestinal. Case: The objective is to present the successful experience of multidisciplinary management of a patient with short bowel syndrome and intestinal failure with progression to intestinal adaptation.This is a newly born premature with intestinal atresia type IV with multiple intestinal atresia who evolved to intestinal failure and required managed with prolonged parenteral nutritional support, multiple antibiotic schemes, prebiotics, multivitamins, enteral nutrition with elemental formula to achieve their adaptation intestinal until lead to a normal diet. The evolution of these patients intestinal failure is a challenge for the health team, as it not only involves the surgicalmanagement of your condition if not basic nutritional support, fluid and electrolyte balance, hepatic dysfunction cholestasis associated infections etc. Discussion: Short bowel syndrome with progression to intestinal failure in children is a condition whose prevalence is increasing worldwide, thanks to advances in neonatal intensive care, neonatal surgery, and nutritional support of patients with conditions such as gastroschisis, omphalocele and necrotizing enterocolitis. Despite the limitations of our health system, it is possible to offer a multidisciplinary and integrated to lead to intestinal adaptation treatment. Caso clínico: O objetivo é apresentar a experiência de sucesso do manejo multidisciplinar de uma paciente com síndrome de intestino curto e falha intestinal com evolução à adaptação intestinal.Se trata de uma recém nascida prematura com atresia intestinal tipo IV com múltiplas atresias intestinais que evolucionou à falha intestinal e requereu manejo com suporte nutricional parental prolongado, múltiplos esquemas antibióticos, probióticos, multivitaminas, nutrição enteral com fórmula elementar, até conseguir sua adaptação intestinal e levar a uma dieta normal. A falha intestinal nestes pacientes é um desafio para a equipe de saúde, devido a que não só implica o manejocirúrgico de sua condição de base, mas também do suporte nutricional, equilíbrio hidroeletrolítico, disfunção hepática por colestase, infeções associadas, etc. Discussão: a síndrome de intestino curto com evolução à falha intestinal em crianças é uma condição cuja prevalência vai em aumento a nível mundial, devido aos avanços no cuidado intensivo neonatal, cirurgia neonatal e no suporte nutricional de pacientes com condições como gastrosquise, onfalocele e enterocolite. Apesar das limitações de nosso sistema de saúde, é possível oferecer um tratamento multidisciplinar e integral para leva-los até a adaptação intestinal.
- Published
- 2015
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- View/download PDF
27. Nutrition in Necrotizing Enterocolitis and Following Intestinal Resection.
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Ou, Jocelyn, Courtney, Cathleen M., Steinberger, Allie E., Tecos, Maria E., and Warner, Brad W.
- Abstract
This review aims to discuss the role of nutrition and feeding practices in necrotizing enterocolitis (NEC), NEC prevention, and its complications, including surgical treatment. A thorough PubMed search was performed with a focus on meta-analyses and randomized controlled trials when available. There are several variables in nutrition and the feeding of preterm infants with the intention of preventing necrotizing enterocolitis (NEC). Starting feeds later rather than earlier, advancing feeds slowly and continuous feeds have not been shown to prevent NEC and breast milk remains the only effective prevention strategy. The lack of medical treatment options for NEC often leads to disease progression requiring surgical resection. Following resection, intestinal adaptation occurs, during which villi lengthen and crypts deepen to increase the functional capacity of remaining bowel. The effect of macronutrients on intestinal adaptation has been extensively studied in animal models. Clinically, the length and portion of intestine that is resected may lead to patients requiring parenteral nutrition, which is also reviewed here. There remain significant gaps in knowledge surrounding many of the nutritional aspects of NEC and more research is needed to determine optimal feeding approaches to prevent NEC, particularly in infants younger than 28 weeks and <1000 grams. Additional research is also needed to identify biomarkers reflecting intestinal recovery following NEC diagnosis individualize when feedings should be safely resumed for each patient. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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28. Promoting intestinal adaptation by nutrition and medication
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Joanne Olieman, Rene M. H. Wijnen, de Barbara Koning, Esther Neelis, Jessie M. Hulst, Edmond H. H. M. Rings, Pediatrics, and Pediatric Surgery
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0301 basic medicine ,Short Bowel Syndrome ,medicine.medical_specialty ,Parenteral Nutrition ,Antisecretory drugs ,Intestinal adaptation ,Nutritional Status ,03 medical and health sciences ,0302 clinical medicine ,Enteral Nutrition ,Internal medicine ,Small intestinal bacterial overgrowth ,Intestine, Small ,medicine ,Humans ,Adaptation (computer science) ,Intensive care medicine ,Small bowel resection ,030109 nutrition & dietetics ,business.industry ,Gastroenterology ,Intestinal failure ,Glucagon-like peptide-2 ,medicine.disease ,Short bowel syndrome ,Glucagon-like peptide-1 ,Adaptation, Physiological ,Parenteral nutrition ,Endocrinology ,030211 gastroenterology & hepatology ,Growth factors ,business - Abstract
The ultimate goal in the treatment of short bowel syndrome is to wean patients off parenteral nutrition, by promoting intestinal adaptation. Intestinal adaptation is the natural compensatory process that occurs after small bowel resection. Stimulating the remaining bowel with enteral nutrition can enhance this process. Additionally, medication can be used to either reduce factors that complicate the adaptation process or to stimulate intestinal adaptation, such as antisecretory drugs and several growth factors. The aim of this review was to provide an overview of the best nutritional strategies and medication that best promote intestinal adaptation.
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- 2016
29. Emerging treatment options for short bowel syndrome: potential role of teduglutide
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null Tee, null Gabe, and Katharina Wallis
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endocrine system ,business.industry ,digestive, oral, and skin physiology ,Gastroenterology ,Treatment options ,1103 Clinical Sciences ,parenteral nutrition ,Review ,intestinal adaptation ,Bioinformatics ,Glucagon-like peptide-2 ,Short bowel syndrome ,medicine.disease ,Teduglutide ,Inflammatory bowel disease ,Intestinal absorption ,chemistry.chemical_compound ,glucagon-like peptide-2 ,Parenteral nutrition ,chemistry ,intestinal failure ,Medicine ,In patient ,business - Abstract
Introduction Current medical management of short bowel syndrome (SBS) involves the use of lifelong parenteral nutrition (PN). Glucagon-like peptide-2 (GLP-2), an important intestinotrophic growth factor has been shown to increase intestinal absorption in SBS through augmentation of post-resection intestinal adaptation. This may lead to the reduction of PN dependence in patients with SBS. Areas covered in review Advancing research of GLP-2 physiology has spurred the growing understanding of the diverse effects of GLP-2. The development of the degradation resistant GLP-2 analog, teduglutide (Gattex(TM), NPS Pharmaceuticals, Bedminster, NJ), has allowed its exploration as a therapeutic agent in a variety of clinical settings. Recent multicenter, placebo-controlled studies of GLP-2 in SBS patients demonstrate meaningful reductions in PN requirements with good safety profiles. The reparative and immunomodulatory effects of teduglutide may also be beneficial in patients with inflammatory bowel disease (IBD). Safety concerns about possible carcinogenic properties during long-term use require ongoing evaluation. Summary GLP-2 appears to offer a novel adjuvant treatment modality for SBS. Promise for its use in other clinical settings like IBD has been shown in small pilot studies.
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- 2011
30. Short bowel syndrome: A review of management options
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Gabriel Rodrigues and Prasad Seetharam
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Male ,Short Bowel Syndrome ,Parenteral Nutrition ,medicine.medical_specialty ,Malabsorption ,malabsorption ,MEDLINE ,Intestinal adaptation ,Review Article ,Risk Assessment ,Severity of Illness Index ,Pharmacotherapy ,intestinal failure ,Severity of illness ,medicine ,Humans ,lcsh:RC799-869 ,Intensive care medicine ,Digestive System Surgical Procedures ,Nutritional Support ,business.industry ,Mortality rate ,Gastroenterology ,Prognosis ,medicine.disease ,Short bowel syndrome ,Combined Modality Therapy ,Surgery ,Intestines ,Transplantation ,Treatment Outcome ,Parenteral nutrition ,lcsh:Diseases of the digestive system. Gastroenterology ,Female ,total parenteral nutrition ,business - Abstract
Extensive resection of the intestinal tract frequently results in inadequate digestion and/or absorption of nutrients, a condition known as short bowel syndrome (SBS). This challenging condition demands a dedicated multidisciplinary team effort to overcome the morbidity and mortality in these patients. With advances in critical care management, more and more patients survive the immediate morbidity of massive intestinal resection to present with SBS. Several therapies, including parenteral nutrition (PN), bowel rehabilitation and surgical procedures to reconstruct bowel have been used in these patients. Novel dietary approaches, pharmacotherapy and timely surgical interventions have all added to the improved outcome in these patients. However, these treatments only partially correct the underlying problem of reduced bowel function and have limited success resulting in 30% to 50% mortality rates. However, increasing experience and encouraging results of intestinal transplantation has added a new dimension to the management of SBS. Literature available on SBS is exhaustive but inconclusive. We conducted a review of scientific literature and electronic media with search terms ′short bowel syndrome, advances in SBS and SBS′ and attempted to give a comprehensive account on this topic with emphasis on the recent advances in its management.
- Published
- 2011
31. Síndrome de intestino corto en niños: actualidades en su diagnóstico y manejo
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R. Cervantes, M. Cazares, J. Cadena, D. Valdovinos, Jaime Ramírez-Mayans, E. Montijo, E. Toro, and F. Zárate
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Pediatrics ,medicine.medical_specialty ,Postresection intestinal failure ,MEDLINE ,Short bowel in children ,Intestinal adaptation ,Ileocecal valve ,Chronic diarrhea ,Weight loss ,medicine ,lcsh:RC799-869 ,Mexico ,business.industry ,México ,Gastroenterology ,medicine.disease ,Short bowel syndrome ,Intestino corto en niños ,Malnutrition ,medicine.anatomical_structure ,Parenteral nutrition ,Falla intestinal posresección ,Adaptación intestinal ,lcsh:Diseases of the digestive system. Gastroenterology ,Intestinal resection ,medicine.symptom ,business - Abstract
ResumenEl síndrome de intestino corto (SIC) se refiere a la suma de alteraciones funcionales que resultan de una reducción crítica en la longitud del intestino, y que en ausencia de un tratamiento adecuado se manifiestan con diarrea crónica, deshidratación crónica, desnutrición, pérdida de peso, deficiencia de nutrimentos y electrolitos, así como falla para crecer que se presenta con mayor frecuencia durante el periodo neonatal. El objetivo de este artículo es realizar una revisión de la literatura médica sobre la definición, las causas más frecuentes de SIC así como entender la fisiopatología, los factores pronósticos y tratamiento.Se realizó una búsqueda de artículos en PubMed, considerando la información existente en niños con SIC de 20 años hasta la fecha, utilizando las palabras clave “síndrome de intestino corto”. De un total de 784 artículos potenciales, se realizó una selección de 82 artículos donde realizamos la revisión de la literatura médica. Los pacientes con SIC son todo un reto para su tratamiento, por lo que se debe establecer un manejo multidisciplinario enfocado en mantener un soporte nutricional óptimo que cubra las necesidades para crecimiento, desarrollo y asimismo, disminuir al máximo la presencia de complicaciones a corto, mediano y largo plazo. El diagnóstico y manejo de un niño con SIC, implica un equipo de profesionales expertos en el manejo gastroenterológico, pediátrico y nutricional. El pronóstico del niño estará en función al manejo oportuno, así como longitud de la resección intestinal y presencia o no de válvula ileocecal.AbstractShort bowel syndrome (SBS) refers to the sum of the functional alterations that are the result of a critical reduction in the length of the intestine, which in the absence of adequate treatment, presents as chronic diarrhea, chronic dehydration, malnutrition, weight loss, nutriment and electrolyte deficiency, along with a failure to grow that is present with greater frequency during the neonatal period. The aim was to carry out a review of the literature encompassing the definition and the most frequent causes of SBS, together with an understanding of its physiopathology, prognostic factors, and treatment.An Internet search of PubMed articles was carried out for the existing information published over the last 20 years on SBS in children, using the keywords “short bowel syndrome”. From a total of 784 potential articles, 82 articles were chosen for the literature review. The treatment of patients presenting with SBS is quite a challenge and therefore it is necessary to establish multidisciplinary management with a focus on maintaining optimal nutritional support that covers the necessities of growth and development and at the same time provides a maximum reduction of short, medium, and long-term complications. The diagnosis and treatment of a child with SBS require a team of professionals that are experts in gastroenterologic, pediatric, and nutritional management. The outcome for the child will be directly related to opportune management, as well as to the length of the intestinal resection and the presence or absence of the ileocecal valve.
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