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Current treatment paradigms in pediatric short bowel syndrome

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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.

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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

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Authors and Affiliations

  1. Doctor of Medicine (MD) Program, Rush Medical College, 600 S. Paulina St, Chicago, IL, 60612, USA

    Raghav Chandra

  2. Section of Pediatric Gastroenterology, Rush University Medical Center, Professional Building, 1725 W. Harrison Street, Suite 710, Chicago, IL, 60612, USA

    Anil Kesavan

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

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Correspondence to Anil Kesavan.

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

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Chandra, R., Kesavan, A. Current treatment paradigms in pediatric short bowel syndrome. Clin J Gastroenterol 11, 103–112 (2018). https://doi.org/10.1007/s12328-017-0811-7

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