Current treatment paradigms in pediatric short bowel syndrome

Clin J Gastroenterol. 2018 Apr;11(2):103-112. doi: 10.1007/s12328-017-0811-7. Epub 2017 Dec 26.

Abstract

Pediatric short bowel syndrome (SBS) is a serious condition which occurs in children with congenital or acquired reduction in length of the small intestine. SBS results in excessive fluid loss, nutrient malabsorption, electrolyte abnormalities, increased susceptibility to infections, parenteral nutrition associated complications and affects weight gain and growth. In children, SBS is debilitating and uniformly fatal without treatment. The primary goal of treatment is to restore enteral autonomy and reduce long-term dependence on parenteral support by increasing the absorptive potential of the remnant intestine. In this review, the medical and surgical management of SBS including pharmacologic agents, parenteral nutrition, dietary strategies, surgical lengthening procedures, and small bowel transplant will be discussed.

Keywords: Intestinal adaptation; Intestinal rehabilitation; Pediatric short bowel syndrome; Small bowel transplantation; Surgical lengthening procedures.

Publication types

  • Review

MeSH terms

  • Child
  • Dietary Supplements
  • Digestive System Surgical Procedures
  • Enteral Nutrition
  • Gastrointestinal Agents / therapeutic use
  • Humans
  • Intestine, Small / surgery
  • Intestine, Small / transplantation
  • Parenteral Nutrition
  • Short Bowel Syndrome / physiopathology
  • Short Bowel Syndrome / therapy*

Substances

  • Gastrointestinal Agents