Gut Liver Axis in Short Bowel Syndrome

Introduction: Short Bowel Syndrome (SBS) is a rare condition characterised by a reduced intestinal nutrient absorbency. It represents the main cause of intestinal failure (IF) in pediatric population. SBS patient management is complex and requires a multidisciplinary approach. The aim of the study was to evaluate levels of blood fatty acid, and the poten- tial contribution of intestinal dysbiosis in aetiology of liver damage in SBS patients Methods: Patients with SBS who underwent surgery from January 2019 to July 2020 at our institute were enrolled. Intraoperative liver biopsies were analyzed and long (LCFAs), medium (MCFAs), linear short (linear SCFAs) and branched short (branched SCFAs) chain fatty acids blood levels were obtained at surgery. Results: 11 pediatric patients with SBS were enrolled. 9 patients underwent liver biopsies. Median age at surgery was 3,7 years (0,3 – 12,5). 7/9 (78%) liver biopsies showed a variable degree of liver damage from peri- portal fibrosis to biliary cirrosis. Blood tests showed 1328,08 μmol/L linear SCFAs (32%), 149,53 μmol/L branched SCFAs (4%), 942,26 μmol/L MCFAs (22%) and 1754,56 μmol/L LCFAs (42%). Conclusions: Most of the analyzed patients had a variable degree of liver damage. We observed that the blood level of fatty acids of the patients is decreased, especially long and short chain fatty acids, potentially implicated in aetiology of liver damage in SBS patients.