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Current Gastroenterology Reports

Erschienen in:

01.12.2019 | Nutrition and Obesity (S McClave, Section Editor)

Controversy in Nutrition Recommendations for Short Bowel Syndrome: How Type of SBS Impacts Response

verfasst von: Kerstin Austin, Sara Bonnes, Harrison Daniel

Erschienen in: Current Gastroenterology Reports | Ausgabe 12/2019

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Abstract

Purpose of Review

This review examines the current recommendations for dietary management of patients living with short bowel syndrome (SBS) and outlines the need for future research to provide optimal care for this unique group of patients.

Recent Findings

Providers caring for patients with SBS lack sufficient data to help guide recommendations regarding diet. The majority of studies are conducted at a single medical institution on a small number of anatomically diverse patients. Multi-center studies would allow for inclusion of a larger number of patients and may lead to more individualized dietary recommendations.

Summary

Patients with short bowel syndrome should be evaluated on an individual basis by a multidisciplinary team including physicians, dieticians, pharmacists, and nurses specializing in the care of these complex patients. Tailoring both medical and nutritional therapy will help realize the overarching goal for these patients of maintaining adequate nutrition with diet and medications, and achieving independence from parenteral support.

DiBaise JK, Parrish CR, Thompson JS. Short bowel syndrome : practical approach to management. Boca Raton: CRC Press, Taylor & Francis Group; 2016.CrossRef

Buchman AL, Scolapio J, Fryer J. AGA technical review on short bowel syndrome and intestinal transplantation. Gastroenterology. 2003;124(4):1111–34. https://doi.org/10.1053/gast.2003.50139a.CrossRefPubMed

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. https://doi.org/10.1016/j.clnu.2014.08.017.CrossRefPubMed

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

Matarese LE. Nutrition and fluid optimization for patients with short bowel syndrome. JPEN J Parenter Enteral Nutr. 2013;37(2):161–70. https://doi.org/10.1177/0148607112469818.CrossRefPubMed

Purdum PP 3rd, Kirby DF. Short-bowel syndrome: a review of the role of nutrition support. JPEN J Parenter Enteral Nutr. 1991;15(1):93–101. https://doi.org/10.1177/014860719101500193.CrossRefPubMed

Klein S. Influence of nutrition support on clinical outcome in short bowel syndrome and inflammatory bowel disease. Nutrition. 1995;11(2 Suppl):233–7.PubMed

Carbonnel F, Cosnes J, Chevret S, Beaugerie L, Ngo Y, Malafosse M, et al. The role of anatomic factors in nutritional autonomy after extensive small bowel resection. JPEN J Parenter Enteral Nutr. 1996;20(4):275–80. https://doi.org/10.1177/0148607196020004275.CrossRefPubMed

Messing B, Crenn P, Beau P, Boutron-Ruault MC, Rambaud JC, Matuchansky C. Long-term survival and parenteral nutrition dependence in adult patients with the short bowel syndrome. Gastroenterology. 1999;117(5):1043–50.CrossRef

10.

Tappenden KA. Pathophysiology of short bowel syndrome: considerations of resected and residual anatomy. JPEN J Parenter Enteral Nutr. 2014;38(1 Suppl):14S–22S. https://doi.org/10.1177/0148607113520005.CrossRefPubMed

11.

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. https://doi.org/10.1007/s11894-014-0392-2.CrossRefPubMed

12.

Berger DL, Malt RA. Management of the short gut syndrome. Adv Surg. 1996;29:43–57.PubMed

13.

Nordgaard I, Hansen BS, Mortensen PB. Colon as a digestive organ in patients with short bowel. Lancet. 1994;343(8894):373–6.CrossRef

14.

Crenn P, Morin MC, Joly F, Penven S, Thuillier F, Messing B. Net digestive absorption and adaptive hyperphagia in adult short bowel patients. Gut. 2004;53(9):1279–86. https://doi.org/10.1136/gut.2003.030601.CrossRefPubMedPubMedCentral

15.

Jeppesen PB, Mortensen PB. Intestinal failure defined by measurements of intestinal energy and wet weight absorption. Gut. 2000;46(5):701–6. https://doi.org/10.1136/gut.46.5.701.CrossRefPubMedPubMedCentral

16.

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.CrossRef

17.

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. https://doi.org/10.1177/0148607110378410.CrossRefPubMed

18.

Harvie ML, Norris MAT, Sevilla WMA. Soluble fiber use in pediatric short bowel syndrome: a survey on prevailing practices. Nutr Clin Pract. 2018;33(4):539–44. https://doi.org/10.1002/ncp.10089.CrossRefPubMed

19.

Woolf GM, Miller C, Kurian R, Jeejeebhoy KN. Nutritional absorption in short bowel syndrome. Evaluation of fluid, calorie, and divalent cation requirements. Dig Dis Sci. 1987;32(1):8–15.CrossRef

20.

• Jeppesen PB, Fuglsang KA. Nutritional therapy in adult short bowel syndrome patients with chronic intestinal failure. Gastroenterol Clin N Am. 2018;47(1):61–75. https://doi.org/10.1016/j.gtc.2017.10.004 Establishes the importance of personalization of dietary recommendations for patient with SBS depending on anatomy. Addresses the goals and challenges in nutrition therapy in SBS patients. CrossRef

21.

Parrish CR, DiBaise JK. Managing the adult patient with short bowel syndrome. Gastroenterol Hepatol (N Y). 2017;13(10):600–8.

22.

Jeppesen PB, Hoy CE, Mortensen PB. Differences in essential fatty acid requirements by enteral and parenteral routes of administration in patients with fat malabsorption. Am J Clin Nutr. 1999;70(1):78–84. https://doi.org/10.1093/ajcn/70.1.78.CrossRefPubMed

23.

Nightingale JM, Lennard-Jones JE, Gertner DJ, Wood SR, Bartram CI. Colonic preservation reduces need for parenteral therapy, increases incidence of renal stones, but does not change high prevalence of gall stones in patients with a short bowel. Gut. 1992;33(11):1493–7.CrossRef

24.

Jeppesen PB, Mortensen PB. Significance of a preserved colon for parenteral energy requirements in patients receiving home parenteral nutrition. Scand J Gastroenterol. 1998;33(11):1175–9.CrossRef

25.

Weser E. The managment of patients after small bowel resection. Gastroenterology. 1976;71(1):146–50.CrossRef

26.

Andersson H, Isaksson B, Sjogren B. Fat-reduced diet in the symptomatic treatment of small bowel disease: metabolic studies in patients with Crohn’s disease and in other patients subjected to ileal resection. Gut. 1974;15(5):351–9.CrossRef

27.

Woolf GM, Miller C, Kurian R, Jeejeebhoy KN. Diet for patients with a short bowel: high fat or high carbohydrate? Gastroenterology. 1983;84(4):823–8.CrossRef

28.

McIntyre PB, Fitchew M, Lennard-Jones JE. Patients with a high jejunostomy do not need a special diet. Gastroenterology. 1986;91(1):25–33.CrossRef

29.

Ovesen L, Chu R, Howard L. The influence of dietary fat on jejunostomy output in patients with severe short bowel syndrome. Am J Clin Nutr. 1983;38(2):270–7. https://doi.org/10.1093/ajcn/38.2.270.CrossRefPubMed

30.

Mitchell WD, Eastwood MA. Faecal bile acids and neutral steroids in patients with ileal dysfunction. Scand J Gastroenterol. 1972;7(1):29–32.CrossRef

31.

Parrish CR. The clinician’s guide to shor bowel syndrome. Pract Gastroenterol. 2005;29:67–106.

32.

Lennard-Jones JE. Oral rehydration solutions in short bowel syndrome. Clin Ther. 1990;12(Suppl A):129–37 discussion 38.PubMed

33.

• Iyer KR, Kunecki M, Boullata JI, Fujioka K, Joly F, Gabe S, et al. Independence from parenteral nutrition and intravenous fluid support during treatment with teduglutide among patients with intestinal failure associated with short bowel syndrome. JPEN J Parenter Enteral Nutr. 2017;41(6):946–51. https://doi.org/10.1177/0148607116680791 This study showed some patients were able to wean off PN completely and transition to oral diet. Anatomy of the patient was an important factor in their response to treatment. CrossRefPubMed

34.

Guo M, Li Y, Li J. Effect of growth hormone, glutamine, and enteral nutrition on intestinal adaptation in patients with short bowel syndrome. Turk J Gastroenterol. 2013;24(6):463–8. https://doi.org/10.4318/tjg.2013.0555.CrossRefPubMed

35.

Wolfe RR, Miller SL, Miller KB. Optimal protein intake in the elderly. Clin Nutr. 2008;27(5):675–84. https://doi.org/10.1016/j.clnu.2008.06.008.CrossRefPubMed

36.

Ferrie S, Allman-Farinelli M, Daley M, Smith K. Protein requirements in the critically ill: a randomized controlled trial using parenteral nutrition. JPEN J Parenter Enteral Nutr. 2016;40(6):795–805. https://doi.org/10.1177/0148607115618449.CrossRefPubMed

37.

Thompson JS, Rochling FA, Weseman RA, Mercer DF. Current management of short bowel syndrome. Curr Probl Surg. 2012;49(2):52–115. https://doi.org/10.1067/j.cpsurg.2011.10.002.CrossRefPubMed

Titel: Controversy in Nutrition Recommendations for Short Bowel Syndrome: How Type of SBS Impacts Response
verfasst von: Kerstin Austin
Sara Bonnes
Harrison Daniel
Publikationsdatum: 01.12.2019
Verlag: Springer US
Erschienen in: Current Gastroenterology Reports / Ausgabe 12/2019
Print ISSN: 1522-8037
Elektronische ISSN: 1534-312X
DOI: https://doi.org/10.1007/s11894-019-0731-4

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Abstract

Purpose of Review

Recent Findings

Summary

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