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Short bowel syndrome in children
1University of Nebraska Medical Center, Joint Section of Pediatric, Gastroenterology and Nutrition, Omaha 68114, USA.
Insights
Short bowel syndrome (SBS) is malabsorption after intestinal resection, often seen in infants. Management focuses on intestinal adaptation and treating complications, with transplantation as a last resort.
Area of Science:
- Pediatric Gastroenterology
- Surgical Gastroenterology
- Nutritional Science
Background:
- Short bowel syndrome (SBS) results from significant small intestinal resection.
- It is a leading cause of intestinal failure in children, frequently presenting in infancy.
- Clinical outcomes are dictated by the resected segment, extent of resection, and subsequent intestinal adaptation.
Purpose of the Study:
- To summarize the pathophysiology and clinical management of short bowel syndrome in pediatric populations.
- To highlight the importance of intestinal adaptation and management of long-term complications.
- To introduce intestinal transplantation as a therapeutic option for refractory cases.
Main Methods:
- Review of existing literature on short bowel syndrome.
- Analysis of clinical presentation, diagnostic criteria, and management strategies.
- Evaluation of outcomes and complications associated with short bowel syndrome.
Main Results:
- The presentation and consequences of SBS are highly dependent on the location and length of the resected bowel.
- Intestinal adaptation is crucial for functional recovery and a primary therapeutic goal.
- Long-term complications include bacterial overgrowth, nutritional deficiencies, and parenteral nutrition-associated liver disease.
Conclusions:
- Effective management of short bowel syndrome requires a multidisciplinary approach focusing on maximizing intestinal function and preventing complications.
- Intestinal transplantation offers a viable option for select patients with SBS who have exhausted other treatment modalities.
- Further research into enhancing intestinal adaptation and managing complications is essential for improving patient outcomes.
Abstract:
Short bowel syndrome is defined as malabsorption following small intestinal resection. There are many causes in children, most of whom present during infancy. The clinical presentation and physiologic consequences depend heavily on the segment of bowel removed and the extent of resection. The remaining intestine has the capacity to adapt anatomically and functionally, and stimulating the adaptation process is a major component of therapy. Clinical management of long-term complications, such as bacterial overgrowth, nutrient deficiency states, and parenteral nutrition-induced liver disease, are often key outcome determinants. The recent availability of intestinal transplantation now provides an additional therapeutic option for patients in whom all other forms of therapy fail.