Our Summary

The research paper is about a condition called necrotizing enterocolitis (NEC) - a severe intestinal disease common in premature babies. The researchers are studying the role of nutrition and feeding practices in preventing and managing NEC.

The paper highlights that the timing of feeds, the speed at which feeds are increased, and continuous feeding do not prevent NEC. The only proven method is feeding a baby breast milk. However, when NEC progresses, it often requires surgical removal of part of the intestine. After surgery, the remaining intestine adapts by increasing its functional capacity.

The researchers also discussed parenteral nutrition (feeding a person intravenously), which may be required if a large portion of the intestine is removed. They noted that there’s a lot we still don’t know about the nutritional aspects of NEC, especially for infants younger than 28 weeks and weighing less than 1000 grams. They also suggested more research is needed to understand when it is safe to restart feeding after a NEC diagnosis.

FAQs

  1. What is the only proven method to prevent necrotizing enterocolitis (NEC) according to the research paper?
  2. How does the remaining intestine adapt after a surgical removal due to NEC progression?
  3. What is parenteral nutrition and when might it be required in managing NEC?

Doctor’s Tip

A helpful tip a doctor might tell a patient about bowel resection is to follow a well-balanced diet that includes plenty of fiber, fruits, and vegetables to promote healthy digestion and prevent constipation. It’s also important to stay hydrated by drinking plenty of water throughout the day. Additionally, regular exercise can help improve bowel function and overall digestive health. Finally, be sure to follow your doctor’s recommendations for post-operative care and attend any follow-up appointments to monitor your recovery progress.

Suitable For

Patients who are typically recommended bowel resection for NEC are premature babies who have severe cases of the disease that do not respond to other treatment methods. In particular, infants younger than 28 weeks and weighing less than 1000 grams are at higher risk for developing NEC and may require surgery to remove part of the intestine. In some cases, a large portion of the intestine may need to be removed, leading to the need for parenteral nutrition to provide essential nutrients intravenously.

It is important for healthcare providers to closely monitor these patients and collaborate with a multidisciplinary team to develop a comprehensive treatment plan that includes both surgical intervention and nutritional support. Further research is needed to better understand the nutritional needs of infants with NEC and to improve outcomes for this vulnerable population.

Timeline

Before bowel resection:

  • Patient may be experiencing symptoms such as abdominal pain, bloating, diarrhea, and/or constipation
  • Patient undergoes diagnostic tests such as imaging scans and blood tests to confirm the need for surgery
  • Patient may be placed on a liquid diet or have their bowel cleared out to prepare for surgery

After bowel resection:

  • Patient undergoes surgery to remove the damaged portion of the intestine
  • Patient may require parenteral nutrition if a large portion of the intestine is removed
  • Remaining intestine adapts by increasing its functional capacity
  • Patient begins the recovery process, which may include pain management, physical therapy, and monitoring for complications
  • Patient gradually resumes eating solid foods and may require dietary modifications to support healing and prevent complications

Overall, the timeline for a patient before and after bowel resection involves a period of preparation, surgery, recovery, and adaptation to the changes in the digestive system. Nutritional support plays a critical role in the management of patients undergoing bowel resection, especially in cases of conditions like NEC.

What to Ask Your Doctor

  1. What is a bowel resection and why is it necessary in the treatment of NEC?
  2. What are the potential risks and complications associated with a bowel resection surgery?
  3. How long is the recovery period after a bowel resection surgery for NEC?
  4. How will a bowel resection surgery impact my baby’s ability to digest and absorb nutrients?
  5. What changes will need to be made to my baby’s feeding regimen after a bowel resection surgery?
  6. How can I ensure my baby is receiving the necessary nutrients and calories post-surgery?
  7. What signs or symptoms should I watch for that may indicate a complication or issue with the surgery site?
  8. Will my baby require parenteral nutrition after the surgery, and if so, for how long?
  9. Are there any long-term effects or considerations to be aware of after a bowel resection surgery for NEC?
  10. Are there any specific dietary guidelines or restrictions that I should follow for my baby following a bowel resection surgery?

Reference

Authors: Ou J, Courtney CM, Steinberger AE, Tecos ME, Warner BW. Journal: Nutrients. 2020 Feb 18;12(2):520. doi: 10.3390/nu12020520. PMID: 32085587