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[The short-bowel syndrome]
1Dĕtská klinika, Fakulní nemocnice, Plzen.
Insights
This study highlights that early enteral feeding aids small bowel adaptation in neonates with short bowel syndrome. Combining parenteral nutrition with enteral feeding improves outcomes for infants with extensive intestinal resection.
Area of Science:
- Pediatric Gastroenterology
- Neonatal Surgery
- Clinical Nutrition
Background:
- Short bowel syndrome (SBS) is a condition resulting from massive intestinal resection, often in the neonatal period.
- Effective management is crucial for long-term outcomes in affected infants.
- Understanding small bowel adaptation mechanisms is key to improving patient prognosis.
Observation:
- The clinical course of five children with SBS post-neonatal massive intestinal resection was assessed.
- Early enteral feeding was identified as a critical factor influencing small bowel adaptive mechanisms.
- Short gut colitis, a complication of enteral nutrition, was observed and managed.
Findings:
- Early enteral feeding post-resection promotes the development of small bowel adaptive mechanisms.
- Sulphasalazine effectively treats short gut colitis associated with enteral nutrition advancement.
- A combined approach of long-term parenteral nutrition and enteral feeding enhances intestinal adaptation.
Implications:
- Optimizing enteral feeding strategies is vital for managing neonatal short bowel syndrome.
- Pharmacological interventions like sulphasalazine can mitigate complications during nutritional therapy.
- Improved adaptation through combined nutritional support significantly enhances the prognosis for neonates with extensive bowel resection.
Abstract:
This study was designed to asses the clinical course of five children with a short bowel syndrome after massive intestinal resection during neonatal period. On the basis of their experience the authors analyze some properties that may be advantageous in this syndrome and discuss the most important factors, including enteral feeding at an early postresection stage, which influence a full development of the small bowel adaptive mechanisms. They point out that so called "short gut colitis", sometimes occurring during advancement of enteral nutrition, can be successfully treated by sulphasalazine. The authors come to the conclusion that the prognosis for newborn infants undergoing an excessive bowel resection is far well thanks to enhancement of the intestinal adaptation by a combination of a long-term parenteral nutrition with enteral feeding.