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European Journal of Gastroenterology & Hepatology:
November 2008 - Volume 20 - Issue 11 - pp 1061-1063
doi: 10.1097/MEG.0b013e3283040cc9
Leading Article

Short bowel syndrome: searching for the proper diet

Tilg, Herbert

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Abstract

* 'Normal' length of the small bowel varies considerably from 320-800 cm; a small bowel length of less than 200 cm predisposes to the development of intestinal failure.

* Prevalence of short bowel syndrome (SBS) is not known; 30% may depend on parenteral nutrition.

* Patients with SBS should always be early assessed for resuming an oral diet.

* Underlying disease and type of surgical procedure have to be taken into consideration for the best care of SBS patients.

Short bowel syndrome occurs subsequent to anatomical and/or functional loss of mainly small bowel. This often-devastating disease leads to weight loss and immune dysfunction. Proper medical management involves adequate substitution and maintenance of fluid, electrolytes, and nutrients. Although several pharmacological therapies such as clonidine, growth hormone, or octreotide have shown promising results in short bowel syndrome, optimal nutritional management is the most important factor in these patients. If enteral nutrition is possible, diet should consist mainly of fat, followed by protein, and less intake of carbohydrates. Supplementary nonprocessed cereals may be beneficial in a certain subgroup of patients. With the recent developments in medical therapy, a balanced diet may allow many patients to become nutritionally autonomous.

© 2008 Lippincott Williams & Wilkins, Inc.

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