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Published on: December 1, 2012
Long-term impact of infantile short bowel syndrome on nutritional status and growth
Joanne F Olieman1, Corine Penning, Marjolein Spoel
1Department of Pediatric Surgery, Erasmus Medical Center, Sophia Children's Hospital, SK 3286, PO Box 2060, 3000 CB Rotterdam, The Netherlands.
Insights
Infantile short bowel syndrome (SBS) survivors often experience shorter stature and lower bone mineral content despite normal weight for height. Long-term follow-up reveals persistent bowel issues compared to healthy individuals.
Area of Science:
- Pediatric Gastroenterology
- Nutritional Science
- Longitudinal Health Studies
Background:
- Short-term adaptation to short bowel syndrome (SBS) is understood, but long-term outcomes remain under-researched.
- Infantile SBS necessitates small bowel resection and often parenteral nutrition, impacting growth and development.
- Evaluating long-term health consequences is crucial for patient management and quality of life.
Purpose of the Study:
- To assess the long-term effects of infantile short bowel syndrome (SBS) on growth, nutritional status, and overall health.
- To compare the long-term health status of individuals with a history of infantile SBS to healthy controls.
- To identify specific areas of concern, such as linear growth, bone health, and bowel function.
Main Methods:
- A cross-sectional study was conducted between 2005-2007.
- Participants included individuals born between 1975-2002 with a history of infantile SBS and prior small bowel resection.
- Data collected included growth parameters (height, weight), nutritional status (BMI, body fat), bone mineral content (BMC), bone mineral density (BMD), energy intake, and defecation patterns, compared against healthy reference values.
Main Results:
- Individuals with infantile SBS showed significantly shorter stature compared to their target height (TH), with 53% of children and 78% of adults below their TH range.
- While weight for height and body fat percentage were generally normal, bone mineral content (BMC) in children was lower than reference values (SDS -1.0).
- Subjects reported significantly higher frequencies of defecation and bowel complaints than healthy controls, despite adequate mean energy intake (91% of estimated average requirements).
Conclusions:
- Infantile SBS is associated with reduced final stature relative to target height.
- Despite generally normal weight and body composition, individuals may have compromised bone mineral content.
- Long-term survivors of infantile SBS experience persistent gastrointestinal issues, including increased bowel movement frequency and complaints.
Abstract:
Short-term bowel adaptation has been documented, but data on long-term effects are scarce. The aim of the present study was to evaluate the long-term consequences of infantile short bowel syndrome (SBS). A cross-sectional assessment (2005-7) of growth, nutritional status, defecation pattern and health status in individuals with a history of infantile SBS, born between 1975 and 2002, were performed. Data were compared with reference values of healthy controls and presented as means and standard deviations or median and ranges. A total of forty subjects (sixteen male and twenty-four female; mean age 14·8 (SD 6·8) years) had received parenteral nutrition during a median of 110 (range 43-2345) d, following small bowel resection. The mean standard deviation scores (SDS) for weight for height and target height (TH) of the children were normal; mean SDS for height for age was - 0·9 (SD 1·3). The median BMI adults was 19·9 (range 17-26) kg/m2; mean SDS for height for age was - 1·0 (range - 2·5 to 1·5). Height in general was significantly shorter than TH, and 53 % of children and 78 % of adults were below TH range. Most subjects had normal body fat percentage (%BF). SDS for total body bone mineral density were generally normal. The SDS for bone mineral content (BMC) of the children were - 1·0 (SD 1·1). Mean energy intake was 91 % of the estimated average requirements. The frequencies of defecation and bowel complaints of the subjects were significantly higher than in healthy controls. In conclusion, infantile SBS results in shorter stature than was expected from their calculated TH. BMC was lower than reference values, but the subjects had normal weight for height and %BF.
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