Our Summary

This research paper discusses a condition in children known as intestinal failure, where the child’s intestine is not able to function normally. This often happens due to a condition called short-bowel syndrome, which is caused by surgical removal of a part of the intestine. The primary approach in managing this condition is to ensure that the child can eat normally and doesn’t need to rely on nutrition given through a vein.

The aim of treatment is to help the intestine adapt while making sure the child’s growth and development are not affected. However, deciding on the best treatment can be challenging due to a lack of comprehensive research on the subject.

The paper also discusses the role of enteral nutrition (food provided through a tube directly into the stomach or small intestine), and offers practical advice on how to progress the diet of children with short-bowel syndrome. It also highlights new trends in nutrition management, such as blending diets, and their relevance to short-bowel syndrome.

Lastly, the paper explores the role of the microbiome (the trillions of microbes that live in our body) in managing this condition, particularly with regard to its influence on the body’s ability to tolerate enteral nutrition and the overgrowth of bacteria in the small intestine.

FAQs

  1. What is pediatric intestinal failure and what causes it?
  2. What is the main goal of nutritional management in children with Short-bowel syndrome?
  3. How does the microbiome influence enteral tolerance in pediatric Short-bowel syndrome?

Doctor’s Tip

A helpful tip a doctor might tell a patient about bowel resection is to follow a specific diet plan to help the intestines heal and adapt after surgery. This may include gradually reintroducing foods, avoiding certain foods that may be difficult to digest, and staying hydrated. It is important to work closely with a dietitian or healthcare provider to create a personalized nutrition plan that meets the patient’s individual needs. Additionally, following any post-operative care instructions and attending follow-up appointments are crucial for monitoring progress and addressing any concerns.

Suitable For

Patients who are typically recommended for bowel resection include those with conditions such as short-bowel syndrome (SBS), intestinal failure, Crohn’s disease, colorectal cancer, diverticulitis, and other gastrointestinal conditions that require removal of a portion of the bowel. In pediatric patients, SBS is the most common indication for bowel resection, often resulting from necrotizing enterocolitis or other congenital abnormalities. These patients may require bowel resection to improve their nutritional status and quality of life. Bowel resection may also be recommended for patients with severe complications such as bowel obstruction, perforation, or recurrent infections that cannot be managed conservatively.

Timeline

  • Before bowel resection:
  1. Patient may experience symptoms such as severe abdominal pain, bloating, diarrhea, or blood in the stool.
  2. Diagnostic tests such as colonoscopy, CT scan, or MRI may be performed to determine the need for surgery.
  3. Patient may undergo pre-operative preparations such as bowel cleansing, fasting, and medication adjustments.
  • After bowel resection:
  1. Patient will be monitored closely in the hospital for complications such as infection, bleeding, or bowel obstruction.
  2. Patient will start on a clear liquid diet and gradually advance to solid foods as tolerated.
  3. Patient may require parenteral nutrition (intravenous feeding) initially if they are unable to tolerate oral intake.
  4. Patient will undergo regular follow-up appointments with healthcare providers to monitor their progress and adjust their treatment plan as needed.

What to Ask Your Doctor

  1. What is the reason for the bowel resection surgery?
  2. What are the potential risks and complications associated with bowel resection?
  3. What is the expected recovery time after bowel resection surgery?
  4. Will I need to make any changes to my diet or lifestyle after the surgery?
  5. How will bowel resection surgery affect my ability to digest food and absorb nutrients?
  6. Will I need to take any medications or supplements after the surgery?
  7. How often will I need follow-up appointments after the surgery?
  8. What signs or symptoms should I watch for that may indicate a complication after the surgery?
  9. Are there any long-term effects or implications of bowel resection surgery that I should be aware of?
  10. Are there any alternative treatments or therapies that may be beneficial for me after bowel resection surgery?

Reference

Authors: Channabasappa N, Girouard S, Nguyen V, Piper H. Journal: Nutr Clin Pract. 2020 Oct;35(5):848-854. doi: 10.1002/ncp.10565. Epub 2020 Aug 19. PMID: 32815247