Neonatal short bowel syndrome: 'rectal feeding' in order to stimulate intestinal growth

Area of Science:

• Neonatal surgery
• Gastroenterology
• Pediatric nutrition

Background:

• Short bowel syndrome (SBS) is a malabsorptive condition resulting from extensive small bowel resection, often necessitating long-term parenteral nutrition.
• Gastroschisis is a congenital abdominal wall defect that can lead to SBS in premature infants.
• Current management of neonatal SBS primarily relies on parenteral nutrition, with limited options for stimulating bowel adaptation.

Observation:

• A premature infant diagnosed with gastroschisis and subsequent SBS was treated with rectal enteral refeeding via a jejunostomy.
• During the period of rectal feeding, the infant experienced bowel lengthening despite ostomy losses.
• The infant was successfully transitioned to oral feeding within a few months post-birth.

Findings:

• Rectal feeding, even with ostomy losses, demonstrated a capacity to promote bowel growth and adaptation in a neonatal SBS case.
• This method provided a means of nutrient delivery that potentially stimulated the remaining bowel segments.
• The observed bowel lengthening suggests a positive response to the rectal feeding stimulus.

Implications:

• Rectal refeeding represents a novel therapeutic strategy for stimulating bowel growth and adaptation in neonatal SBS.
• This technique may offer an alternative or adjunct to parenteral nutrition, potentially reducing associated complications.
• Further research into rectal feeding could optimize management protocols for infants with SBS, improving long-term outcomes.