Use of percutaneous endoscopic gastrostomy or percutaneous endoscopic jejunostomy in short bowel syndrome

Patients who have short bowel syndrome (SBS) and concomitant intestinal failure have insufficient functional capacity to absorb sufficient nutrients, electrolytes, and/or fluid to sustain independent life. As such, these patients require specialized nutritional support. Although parenteral nutrition is often necessary, at least initially, the therapeutic goal should be to enhance intestinal adaption and enteral nutrient assimilation, and thereby reduce parenteral nutrition requirements. The induction of hyperphagia is critical. Enteral intake also can be enhanced through enteric tube feeding. There are, however, insufficient data to recommend the universal use of a peptide-based formula (versus a polymeric formula), although the use of such a formula may be considered in individual patients in whom the clinician has compared nutritional outcome with the two types of formulas.