Role of parenteral nutrition in patients with short bowel syndrome

More patients with extensive resection of the small bowel--secondary to regional enteritis, mesenteric infarction, cancer, etc.--are surviving perioperative treatment. To avoid nutrition-caused malabsorption and to maintain body composition, intravenous nutrition is initiated with a silastic atrial catheter in the immediate postoperative period. The patients are trained in "home hyperalimentation" procedures designed to allow normal nutrition to be maintained during the months required for bowel adaptation to occur. Because bowel adaptation to the absorption and transport of foodstuffs is in part dependent on the intraluminal presence of foodstuffs, elemental and regular diets are ingested during the period of intravenous support which may last for years. By using combined oral and intravenous nutrition, approximately 20 per cent of patients with short bowel syndrome eventually can take sufficient oral nutrients to sustain life.