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Clinical Journal of Gastroenterology

, Volume 11, Issue 2, pp 103–112 | Cite as

Current treatment paradigms in pediatric short bowel syndrome

  • Raghav Chandra
  • Anil Kesavan
Clinical Review

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

Pediatric short bowel syndrome Intestinal rehabilitation Intestinal adaptation Surgical lengthening procedures Small bowel transplantation 

Abbreviations

SBS

Short bowel syndrome

PN

Parenteral nutrition

NEC

Necrotizing enterocolitis

SIBO

Small intestinal bacterial overgrowth

GLP-2

Glucagon-like peptide-2

LCT

Long-chain triglycerides

MCT

Medium-chain triglycerides

Mg

Magnesium

ICU

Intensive care unit

DVT

Deep venous thrombosis

IFLAD

Intestinal failure-associated liver disease

IV

Intravenous

LILT

Longitudinal intestinal lengthening and tailoring

STEP

Serial transverse enteroplasty

SRSB

segmental reversal of the small bowel

SBTX

Small bowel transplantation

ACR

Acute cellular rejection

GVHD

Graft vs. host disease

PTLD

Post-transplant lymphoproliferative disease

IL

Interleukin

EBV

Epstein-Barr virus

Notes

Author contributions

All authors influenced the concept, wrote and revised the manuscript and approved of the final version.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

Compliance with ethical standards

Conflict of interest

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Human rights

All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

Informed consent was obtained from all patients for being included in the study.

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Copyright information

© Japanese Society of Gastroenterology 2017

Authors and Affiliations

  1. 1.Doctor of Medicine (MD) ProgramRush Medical CollegeChicagoUSA
  2. 2.Section of Pediatric GastroenterologyRush University Medical CenterChicagoUSA

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