Nutrition and Dietary Supplements (Nov 2024)
Non-surgical Interventions for Improving Nutrient Absorption in Pediatric Short Bowel Syndrome
Abstract
Joel Faintuch,1 Andre Dong Won Lee,2 Salomao Faintuch,3 Asher Mishaly,4 Francisco Juarez Almeida Karkow5 1Department of Gastroenterology, Sao Paulo University Medical School, Sao Paulo, SP, Brazil; 2Liver and Digestive Organs Transplantation Service, Hospital Das Clinicas, Sao Paulo, Brazil; 3Interventional Radiology, Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; 4Private Practice, Internal Medicine, Sao Paulo, Brazil; 5Department of Clinical Nutrition, Fatima Faculty of Nutrition, Caxias do Sul, RGS, BrazilCorrespondence: Joel Faintuch, Senior Professor of Gastroenterology, Hospital das Clínicas, Avenida Eneias C. Aguiar 255, 9th Floor, Rm 9077, Sao Paulo, SP, 05403-000, Brazil, Email [email protected]: As recently as 1990, short bowel syndrome in infants with less than 6 cm of remaining small intestine beyond the ligament of Treitz was defined as irreversibly lethal, and withholding further treatment was considered reasonable at that time (Reference deleted, Reviewer 2 item 1). Intestinal transplantation was already available, however not highly reliable. Nowadays transplantation is associated with long-term survival, even though indications are not expanding. On the contrary, they are shrinking, particularly for children as non-transplant handling. Surgical lengthening of the remaining gut, and more recently by enterohormone supplementation to stimulate diarrhea reversal and gut rehabilitation, is permitting encouraging rates of long-term survival. The purpose of this study was to review current non-surgical interventions aiming at parenteral nutrition weaning and intestinal failure reversal in the short bowel syndrome population, with emphasis on pediatric cases.Keywords: intestinal failure, gut rehabilitation, enterohormones, GLP-2, GLP-1, food supplements, short bowel syndrome
