Seminars in Perinatology
Volume 31, Issue 2 , Pages 104-111 , April 2007

Nutritional Management of Infants with Short Bowel Syndrome

  • Jacqueline J. Wessel, MEd, RD, CNSD, CSP, CLE

      Affiliations

    • Corresponding Author InformationAddress reprint requests to Jacqueline J. Wessel, MEd, RD, CNSD, CSP, CLE, Neonatal Nutritionist, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229-3039.
  • ,
  • Samuel A. Kocoshis, MD

References 

  1. O’Keefe SJ, Buchman AL, Fischbein TM, et al. Short bowel syndrome and intestinal failure: consensus definitions and overview. Clin Gastroenterol Hepatol. 2006;4:6–10
  2. Cassaccia G, Trucchi A, Spirydakis I, et al. Congenital intestinal anomalies, neonatal short bowel syndrome, and prenatal counseling. J Pediatr Surg. 2006;41:804–807
  3. Spencer AU, Neaga A, West B, et al. Pediatric short bowel syndrome: redefining predictors of success. Ann Surg. 2005;242:403–408
  4. Siebert JB. Small intestine length in infants and children. Am J Dis Child. 1980;134:593–595
  5. Weaver LT, Austin S, Cole TJ. Small intestinal length: a factor essential to gut adaptation. Gut. 1991;32:1321–1323
  6. Touloukian RJ, Smith GJ. Normal intestinal length in preterm infants. J Pediatr Surg. 1983;18:720–723
  7. Caniano DA, Starr J, Ginn-Pease ME. Extensive short bowel syndrome in neonates: outcome in the 1980s. Surgery. 1989;105:119–124
  8. Ziegler MM. Short bowel syndrome in infancy (Etiology and management). Clin Perinatol. 1986;13:167
  9. Taylor SF, Sokol RJ. Infants with short bowel syndrome. In:  Hay WW editors. Neonatal Nutrition and Metabolism. St. Louis, MO: Mosby Year Book; 1881;p. 457
  10. Kocoshis S. Small intestinal failure in children. Curr Treat Options Gastroenterol. 2001;4:423–432
  11. Andorsky DJ, Lund DP, Lillehei CW, et al. Nutritional and other postoperative management of neonates with short bowel syndrome correlates with clinical outcomes. J Pediatr. 2001;139:27–33
  12. Sondheimer JM, Cadnapahornchai M, Sontag M, et al. Predicting the duration of dependence on parenteral nutrition after neonatal intestinal resection. J Pediatr. 1998;132:80–84
  13. Duran B. The effects of long term total parenteral nutrition on gut mucosal immunity in children with short bowel syndrome: a systematic review. BMC Nursing. 2005;4:2–24
  14. Warner BW, Erwin CR. Critical roles for EGF receptor signaling during resection-induced intestinal adaptation. J Pediatr Gastroenterol Nutr. 2006;43(suppl 1):S68–S73
  15. Sigalet DL, Martin GR, Butzner JD, et al. A pilot study of the use of epidermal growth factor in pediatric short bowel syndrome. J Pediatr Surg. 2005;40:763–768
  16. Jeppesen PB. Glucagon-like peptide. II. Update of the recent clnical trials. Gastroenterology. 2006;130:S127–S131
  17. Sigalet DL, Martin G, Meddinger J, et al. GLP-2 levels in infants with intestinal dysfunction. Pediatr Res. 2004;56:371–376
  18. Martin GR, Beck PL, Sigalet DL. Gut hormones and short bowel syndrome: the enigmatic role of glucagon-like peptide-2 in the regulation of intestinal adaptation. World J Gastroenterol. 2006;14:4117–4129
  19. Sigalet DL, Bawazir O, Martin GR, et al. Glucagon-like peptide-2 induces a specific pattern of adaptation in remnant jejunum. Dig Dis Sci. 2006;51:1557–1566
  20. Byrne TA, Wilmore DW, Iyer K, et al. growth hormone, glutamine, and an optimal diet reduce parenteral nutrition inpatients with short bowel syndrome. Ann Surg. 2005;242:655–661
  21. Kollman KA, Lien EL, Vanderhoof JA. Dietary lipids influence intestinal adaptation after massive small bowel resection. J Pediatr Gastroenterol Nutr. 1999;28:41–45
  22. Kelly DA. Intestinal failure-associated liver disease: what do we know today?. Gastroenterology. 2006;130:S70–S71
  23. Peden VH, Witzleben CL, Skelton MA. Total parenteral nutrition. J Pediatr. 1971;778:180–181
  24. Touloukian RJ, Seashore JH. Hepatic secretory obstruction with total parenteral nutrition in the infant. J Pediatr Surg. 1975;10:353–360
  25. Forchielli M, Walker WA. Nutritional factors contributing to the development of cholestasis during total parenteral nutrition. Adv Pediatr. 2003;50:245–267
  26. Moss RL, Das JB, Raffensperger JG. Necrotizing enterocolitis and total parenteral nutrition-associated cholestasis. Nutrition. 1996;12:340–343
  27. Sondheimer JM, Asturias E, Cadnapaphornchai M. Infection and cholestasis in neonates with intestinal resection and long term parenteral nutrition. J Pediatr Gastroenterol Nutr. 1998;27:131
  28. Yamanouchi T, Suita S, Masumoto K. Non-protein energy overloading induces bacterial translocation during total parenteral nutrition in newborn rabbits. Nutrition. 1998;14:443;337
  29. Hata S, Nezu R, Kubota A, et al. Effect of amino acids in total parenteral nutrition on cholestasis in newborn rabbits. J Pediatr Surg. 1994;29:892–895
  30. Vileisis RA, Inwood RJ, Hunt CF. Prospective controlled study of parenteral nutrition-associated cholestatic jaundice (Effect of protein intake). J Pediatr. 1980;96:893
  31. Colomb V, Jobert-Giraud A, Lacaille F, et al. Role of lipid emulsions in cholestasis associated with long term parenteral nutrition in children. J Parenter Enter Nutr. 2000;24:345–350
  32. Nishimura M, Yamaguchi M, Naito S, et al. Soybean oil fat emulsion to prevent TPN-Induced Liver Disease: Possible molecular mechanisms and clinical implications. Biol Pharm Bull. 2006;29:855
  33. Gura KM, Duggan CP, Collier SB, et al. Reversal of parenteral nutrition associated liver disease in two infants with short bowel syndrome using parenteral fish oil: implications for future management. Pediatrics. 2006;118:e197–e201
  34. Alaedeen DU, Walsh MC, Chwals WJ. Total parenteral nutrition-associated hyperglycemia correlates with prolonged mechanical ventilation and hospital stay in septic infants. J Pediatr Surg. 2006;41:239–244
  35. Hall NJ, Peters M, Eaton S, et al. Hyperglycemia is associated with increased morbidity and mortality in neonates with necrotizing enterocolitis. J Pediatr Surg. 2004;39:898–901
  36. Alaedeen DU, Queens AL, Leung E, et al. Reactive protein determined injury severity: length of stay predictor in surgical infants. J Pediatr Surg. 2004;39:1832–1834
  37. Chwals WJ, Letton RW, Jamie A, et al. Stratification of injury severity using energy expenditure response in surgical infants. J Pediatr Surg. 1995;30:1161–1164
  38. Cai W, Tao Y, Tang Q, et al. Study on energy metabolism in perioperative infants. Eur J Pediatr Surg. 2006;16:227–230
  39. Pierro A. Metabolism and nutritional support in the surgical neonate. J Pediatr Surg. 2002;37:811–822
  40. Jones MO, Pierro A, Hammond P, et al. Glucose utilization in the surgical newborn infant receiving total parenteral nutrition. J Pediatr Surg. 1993;28:1121–1125
  41. Lee OK, Johnston L. A systematic review for effective management of central venous catheters and catheter sites in acute care pediatric patients. Worldviews Evid Based Nurs. 2005;2:4–13
  42. Suita S, Masumoto K, Yamanouchi T, et al. Complications in neonates with short bowel syndrome and long term parenteral nutrition. J Parenter Enter Nutr. 1999;23:S106
  43. Blaszyk H, Wild PJ, Oliveira A, et al. Hepatic copper in patients receiving long term total parenteral nutrition Hepatic copper in patients receiving long-term total parenteral nutrition. J Clin Gastroenterol. 2005;39:318–320
  44. Hurwitz M, Garcia MG, Poole RL, et al. Copper deficiency during parenteral nutrition: a report of four pediatric cases. Nutr Clin Prac. 2004;19:305–308
  45. Fuhrmann MP, Hermann V, Masidonski P, et al. Pancytopenia after removal of copper from total parenteral nutrition. J Parenter Enter Nutr. 2000;24:361–366
  46. Fujita M, Itakura T, Takagi Y, et al. Copper deficiency during total parenteral nutrition (Clinical analysis of three cases). J Parenter Enter Nutr. 1989;13:421–425
  47. Cohran V, Heubi J, Kocoshis SA. Copper Deficiency in Total Parenteral Nutrition (TPN)-Bound Patients. J Pediatr Gastroenterol Nutr. 2003;37:389
  48. Krug SK. Parenteral nutrition: vitamins, minerals, and trace elements. In:  Groh-Wargo S,  Thompson M,  Cox JH editor. Nutritional Care of High Risk Newborns. Chicago, IL: Precept Press; 2000;p. 165
  49. Erikson KM, Thompson K, Ashner J, et al. Manganese neurotoxicity: a special focus on neonates. Pharmacol Ther. 2007;113:369–377
  50. Shulman RJ. Zinc and copper balance studies in infants receiving TPN. Am J Clin Nutr. 1989;49:879
  51. Friel JK, Gibson RS, Peliowski A, et al. Serum zinc, copper, and selenium concentrations in preterm infants receiving parenteral nutrition supplemented with zinc and copper. J Pediatr. 1984;104:736
  52. Zlotkin SH, Buchanan BE. Meeting zinc and copper intake requirements in the parenterally fed preterm and full term infant. J Pediatr. 1983;103:441
  53. Zlotkin SH. Nutrient interactions with total parenteral nutrition (Effect of histidine and cysteine intake on urinary zinc excretion). J Pediatr. 1989;114:859
  54. Latimer JS, McLain CJ, Sharp HI. Clinical zinc deficiency during zinc supplemented parenteral nutrition. J Pediatr. 1980;97:434
  55. Weber TB, Sears N, Davies B, et al. Clinical spectrum of zinc deficiency in pediatric patients receiving total parenteral nutrition. J Pediatr Surg. 1981;16:236
  56. Dahlstrom KA, Ament ME, Medhin MG, et al. Serum trace elements in children receiving long term parenteral nutrition. J Pediatr. 1986;109:625–630
  57. Papageorgiou T, Zacharoulis D, Xenos D, et al. Determination of trace elements (Cu, Zn, Mn, Pb) and magnesium by atomic absorption in patients receiving total parenteral nutrition. Nutrition. 2002;18:32–34
  58. Schwartz KB, Ternberg JL, Bell MJ, et al. Sodium needs of infants and children with ileostomy. J Pediatr. 1983;102:509
  59. Bower TR, Pringle KC, Soper RT. Sodium deficit causing decreased weight gain and metabolic acidosis in infants with an ileostomy. J Pediatr Surg. 1988;23:567
  60. Mews CF. Topics in neonatal nutrition: early ileostomy closure to prevent chronic salt and water losses in infants. J Perinatol. 1992;12:297
  61. Sacher P, Hirsig J, Gresser J, et al. The importance of oral sodium replacement in ileostomy patients. Prog Pediatr Surg. 1989;24:226
  62. Bohnhorst B, Muller S, Dordelmann M, et al. Early feeding after necrotizing enterocolitis in preterm infants. J Pediatr. 2003;143:484–487
  63. Biller JA. Short bowel syndrome. In:  Grand RJ,  Sutphen JL,  Dietz WH editor. Pediatric Nutrition. Boston, MA: Butterworths; 1987;p. 481
  64. Hyman PE, Garvey TQ, Abrams CE. Tolerance to intravenous ranitidine. J Pediatr. 1987;110:794–797
  65. Hyman PE, Garvey TQ, Harada T. Effect of ranitidine on gastric acid hypersecretion in an infant with short bowel syndrome. J Pediatr Gastroenterol Nutr. 1985;4:316–319
  66. Hyman PE, Everett SL, Harada T. Gastric acid hypersecretion in short bowel syndrome in infants (Association with extent of resection and enteral feeding). J Pediatr Gastroenterol Nutr. 1987;5:191–197
  67. Parker P, Stroop S, Greene H. A controlled comparison of continuous versus intermittent feeding in the treatment of infants with intestinal disease. J Pediatr. 1987;99:360
  68. Richardson L, Banerjee S, Rabe H. What is the evidence on the practice of mucous fistula refeeding in neonates with short bowel syndrome. J Pediatr Gastroenterol Nutr. 2006;43:267–270
  69. Wong KK, Lan LC, Lin SC, et al. Mucous fistula refeeding in premature neonates with enterostomies. J Pediatr Gastroenterol Nutr. 2004;39:43–45
  70. Gardner VA, Walton JM, Chessell L. A case study utilizing an enteral refeeding technique in a premature infant with short bowel syndrome. Adv Neonatal Care. 2003;3:258–268
  71. Al-Harbi K, Walton JM, Gardner V, et al. Mucous fistula refeeding in neonates with short bowel syndrome. J Pediatr Surg. 1999;34:1100–1102
  72. Koruda MJ, Rolandelli RH, Settle RG, et al. The effect of a pectin supplemented elemental diet on intestinal adaptation to massive small bowel resection. J Parenter Enteral Nutr. 1986;10:343–350
  73. Roth JA, Frankel WL, Zhang W, et al. Pectin improves colonic function in rat short bowel syndrome. J Surg Res. 1995;58:240–246
  74. Sales TR, Torres MO, Couto CM, et al. Intestinal adaptation in short bowel syndrome without tube feeding or home parenteral nutrition: report of four consecutive cases. Nutrition. 1998;14:608–612
  75. Booth IW. Enteral nutrition as primary therapy in short bowel syndrome. Gut. 1994;35:S69–S72
  76. Finkel Y, Brown G, Smith HJ, et al. The effects of a pectin-supplemented elemental diet in a boy with short gut syndrome. Acta Paediatr Scand. 1990;79:1983–1986
  77. Drenckpohl D, Hocker J, Shareef M, et al. Adding dietary green beans resolves the diarrhea associated with bowel surgery in neonates: a case study. Nutr Clin Prac. 2005;20:674–677
  78. Wessel JJ, Klotz K. Feeding problems in infants with short bowel syndrome. ASPEN Clinical Congress Poster. 1994;
  79. Linsheid TR, Tarnowski KJ, Rasnake LK, et al. Behavioral treatment o food refusal in a child with short gut syndrome. J Pediatr Psych. 1987;12:451
  80. Heird WC, Schwartz SM, Hansen IH. Colostrum induced enteric mucosal growth in beagle puppies. Pediatr Res. 1984;18:512A
  81. Nagy ES, Paris MC, Taylor RG, et al. Colostrum protein concentrate enhances intestinal adaptation after small bowel resection in juvenile pigs. J Pediatr Gastroenterol Nutr. 2004;39:337–342
  82. Brewster D, Kukuruzovic R, Haase A. Short bowel syndrome, intestinal permeability and glutamine. J Pediatric Gastroenterol Nutr. 1998;27:614–616
  83. Bines J, Francis D, Hill D. Reducing parenteral requirement in children with short bowel syndrome: impact of an amino acid-based complete infant formula. J Pediatr Gastroenterol Nutr. 1998;26:123–128
  84. Gouttebel MC, Saint-Aubert B, Colette C, et al. Intestinal adaptation in patients with short bowel syndrome: measurement by calcium absorption. Dig Dis Sci. 1989;34:709–715
  85. Alkalay AL, Fleisher DR, Pomerance JJ, et al. Management of premature infants with extensive bowel resection with high volume enteral exudates. Isr J Med Sci. 1995;31:298–302
  86. Perlmutter DH, Boyle JT, Campos JM, et al. D-lactic acidosis in children (An unusual metabolic complication of small bowel resection). J Pediatr. 1983;102:234
  87. Gurevitch J, Sala B, Jonas A, et al. D-lactic acidosis: a treatable encephalopathy in pediatric patients. Acta Paediatr. 1993;82:11
  88. Bongaerts G, Tolboom J, Naber T, et al. D-lactic acidosis and aciduria in pediatric and adult patients with short bowl syndrome. Clin Chem. 1995;41:107
  89. Uchida H, Yamamoto H, Kisaki Y, et al. D-lactic acidosis in short bowel syndrome managed with antibiotics and probiotics. J Pediatr Surg. 2004;39:634–636
  90. Kunz AN, Noel JM, Fairchok MP. Two cases of Lactobacillus bacteremia during probiotic treatment of short gut syndrome. J Pediatr Gastroenterol Nutr. 2004;38:407–408
  91. De Groote MA, Frank DN, Dowell E, et al. Lactobacillus rhamnosus GG bacteremia associated with probiotic use in a child with short gut syndrome. Pediatr Infect Dis. 2005;24:278–280
  92. Quiros-Tejeira RE, Ament ME, Reyen L, et al. Long-term nutritional support and intestinal adaptation in children with short bowel syndrome: a 25 year experience. J Pediatr. 2004;145:157–163
  93. Gonzalez HF, Perez NB, Malpeli A, et al. Nutrition and immunological status in long-term follow up of children with short bowel syndrome. J Parenter Enter Nutr. 2003;29:186–191
  94. Goulet O, Baglin-Gobet S, Talbotec C, et al. Outcome and long term growth after extensive small bowel resection in the neonatal period: a survey of 87 children. Eur J Pediatr Surg. 2005;15:95–101

PII: S0146-0005(07)00031-6

doi: 10.1053/j.semperi.2007.02.009

Seminars in Perinatology
Volume 31, Issue 2 , Pages 104-111 , April 2007