Food Rehabilitation in Paediatric Population with Short Bowel Syndrome

Introduction: Short Bowel Syndrome (SBS) patients requires a challenging and multidisciplinary management. Different therapeutic strategies were reported in literature, including intestinal lengthening surgery, enteral nutrition, total parenteral nutrition (PN) and, in the most advanced stages of the disease, intestine transplantation. The aim of the study is to analyse and describe the nutritional rehabilitation process in paediatric patients with SBS, as appropriate nutritional strategies were not reported in literature. Methods: A retrospective study of SBS children undergone intestinal lengthening surgery between January 2018 and July 2020 was performed. Data collected included: gestational age, birth weight, SBS aetiology, PN duration, age of surgery, small bowel remnant, presence of ileocecal valve, stomas maintenance period and laboratory parameters. Each patient was analysed about clinical conditions with laboratory parameters such as evaluation of blood sugar, urea, haemoglobin, total and specific proteins such as albumin, calcitonin, electrolytes and coagulation factors. Nutritional status was also assessed with adequate instrumental tests. Other findings were evaluated: presence of gastrointestinal symptoms, number and type of stool evacuation, enteral/parenteral nutrition, intestinal decontamination, anti-reflux therapy. Local ethical was approved. Results: Sixteen patients were included (44%M, 56%F) with median age of 5 years (range 1-16 years) and with 18,75% over 10 years old. Patients with duodenal resection had iron and folic acid deficiency, while lack of calcium and zinc was reported following jejunostomy. Ileal resection was associated with both fat-soluble (such as vit. A and vit. D) and water-soluble (as vit. B12, cobalamin) vitamins deficiency. Conclusion: Main nutritional issues related to the different intestinal tract resected were studied in order to identify personalized nutritional plants for rehabilitation. Nutritional rehabilitation presents a central role for intestinal adaptation and general condition improvement. Some previous studies also recommended a poor simple carbohydrates diet in SBS patients feeding, but appropriated nutritional strategies were not still described.