Document Detail


Indications for specific therapy in the rehabilitation of patients with the short-bowel syndrome.
MedLine Citation:
PMID:  14642856     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Diarrhoea, malabsorption and malnutrition characterize the short-bowel syndrome. Following the initial intestinal resection, complications such as fistulas and intra-abdominal abscesses may occur, but these usually resolve with appropriate surgical care. All residual intestine should be placed in continuity before serious attempts at rehabilitation with oral feedings are initiated. Small hourly oral feedings composed of food items high in complex carbohydrate and low in fat are started when appropriate and the diet is gradually increased as intestinal adaptation occurs. The goal during this process is to prevent diarrhoea and allow the formation of semiformed stools. With time, parenteral nutrition (PN) can be reduced, and the time required depends on both length of residual bowel and the particular anatomy involved-for example, the presence or absence of the colon. A programme of optimal diet plus growth hormone (0.1 mg/kg) and oral glutamine (30 g/day) enhances the adaptive process and allows many patients independence from PN. However, those with extremely short segments of jejuno-ileum (<50 cm) and no colon have excessive fluid and electrolyte losses, and intestinal transplantation may be the only therapy which allows such patients to be independent of PN.
Authors:
Douglas W Wilmore
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Best practice & research. Clinical gastroenterology     Volume:  17     ISSN:  1521-6918     ISO Abbreviation:  Best Pract Res Clin Gastroenterol     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2003-12-03     Completed Date:  2004-04-08     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  101120605     Medline TA:  Best Pract Res Clin Gastroenterol     Country:  England    
Other Details:
Languages:  eng     Pagination:  895-906     Citation Subset:  IM    
Affiliation:
Department of Surgery and the Laboratories for Surgical Metabolism and Nutrition, Brigham and Women's Hospital, Harvard Medical School, Huntington Avenue, 75 Francis St, Boston MA 02115, USA. dwilmore@pertners.org
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MeSH Terms
Descriptor/Qualifier:
Dietary Carbohydrates / administration & dosage
Dietary Fats / administration & dosage
Dietary Fiber / administration & dosage
Dietary Proteins / administration & dosage
Humans
Intestines / transplantation
Short Bowel Syndrome / diet therapy*,  rehabilitation*,  surgery
Chemical
Reg. No./Substance:
0/Dietary Carbohydrates; 0/Dietary Fats; 0/Dietary Proteins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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