Our Summary

Short-Bowel Syndrome (SBS) is a condition in children where the small intestine can’t absorb nutrients properly. It can be caused by birth defects, surgery, or illness. This syndrome is the main reason why children suffer from intestinal failure and why half of patients need nutrition delivered through a vein at home. The disease is life-altering and life-threatening because the remaining part of the intestine can’t balance protein, fluid, and other essential nutrients without help.

One way to manage SBS is through parenteral nutrition (PN), where nutrients are given directly into the bloodstream. This method has improved care for SBS, reducing deaths and improving overall health. However, long-term use of PN can lead to other issues like liver disease and infections related to the catheter.

This paper reviews current research on managing SBS in children, focusing on factors that can predict outcomes. Recent research shows that standardized treatment has improved the quality of life for these patients, and that increasing knowledge in the field has reduced death and illness. Treatment decisions should be made by a team of medical experts, including neonatologists, pediatric surgeons, gastroenterologists, pediatricians, nutritionists, and nurses.

Key elements to improving outcomes include careful monitoring of nutritional status, reducing reliance on PN, introducing food into the diet as soon as possible, and preventing and aggressively treating infections. More research initiatives and data registries are needed to personalize treatments, improve quality of life, and reduce costs.

FAQs

  1. What is Short-Bowel Syndrome (SBS) and what causes it in children?
  2. How is parenteral nutrition (PN) used to manage SBS and what are its potential side effects?
  3. What are the key elements in improving outcomes for children with SBS?

Doctor’s Tip

The doctor might tell the patient that it is important to follow a strict dietary plan and take any prescribed medications to help manage their condition. They may also recommend regular follow-up appointments to monitor progress and make any necessary adjustments to their treatment plan. Additionally, the doctor may advise the patient to avoid certain foods that may exacerbate their symptoms and to stay hydrated by drinking plenty of water. It is important for the patient to communicate any changes or concerns with their doctor to ensure they are receiving the best care possible.

Suitable For

Patients who are typically recommended intestinal resection include those with:

  • Short-Bowel Syndrome (SBS) that is not responding well to other treatments
  • Severe complications from SBS such as frequent infections, liver disease, or failure to thrive
  • Inflammatory bowel disease such as Crohn’s disease or ulcerative colitis
  • Intestinal obstruction or blockage
  • Intestinal tumors or polyps
  • Traumatic injury to the intestine

The decision to recommend intestinal resection is made by a team of medical professionals based on the individual patient’s specific condition and needs. It is important for patients to work closely with their healthcare team to understand the risks and benefits of the surgery and to be involved in the decision-making process.

Timeline

Before intestinal resection:

  • Patient is diagnosed with Short-Bowel Syndrome (SBS) due to the small intestine’s inability to absorb nutrients properly.
  • Patient may undergo surgeries, treatments, or experience illness that lead to intestinal failure.
  • Patient may require parenteral nutrition (PN) to receive nutrients directly into the bloodstream.
  • Long-term use of PN can lead to complications like liver disease and infections related to the catheter.

After intestinal resection:

  • Patient undergoes intestinal resection surgery to remove damaged or non-functioning parts of the small intestine.
  • Patient may still require PN post-surgery to support nutrition while the intestine heals.
  • Treatment team of medical experts monitor patient’s nutritional status, introduce food into the diet, and prevent/treat infections.
  • Research and data registries are utilized to personalize treatments, improve quality of life, and reduce costs for patients with SBS.

What to Ask Your Doctor

Questions a patient should ask their doctor about intestinal resection and Short-Bowel Syndrome:

  1. What is the reason for my intestinal resection surgery and how will it affect my digestive system?
  2. What are the potential complications or risks associated with intestinal resection surgery?
  3. Will I be at risk for developing Short-Bowel Syndrome after the surgery?
  4. How will Short-Bowel Syndrome affect my ability to absorb nutrients and maintain proper nutrition?
  5. What are the treatment options for managing Short-Bowel Syndrome, including parenteral nutrition?
  6. What are the potential long-term effects of using parenteral nutrition for managing Short-Bowel Syndrome?
  7. How can I work with a team of medical experts to create a personalized treatment plan for managing Short-Bowel Syndrome?
  8. What are the key factors that can predict outcomes for patients with Short-Bowel Syndrome?
  9. How can I monitor my nutritional status and prevent complications related to Short-Bowel Syndrome?
  10. Are there any ongoing research initiatives or data registries that I can participate in to improve my treatment and quality of life?

Reference

Authors: Caporilli C, Giannì G, Grassi F, Esposito S. Journal: Nutrients. 2023 May 17;15(10):2341. doi: 10.3390/nu15102341. PMID: 37242224