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MEDICAL NUTRITION THERAPY IN SHORT BOWEL SYNDROME AND FOOD INTERVENTIONS IN INTESTINAL ADAPTATION

Year 2021, Volume: 24 Issue: 2, 291 - 297, 25.06.2021
https://doi.org/10.17049/ataunihem.643472

Abstract

The 'normal' length of the small intestine ranges from 320 to 800 cm. short bowel syndrome is defined as the small bowel length less than 200 cm. Short bowel syndrome is a clinical manifestation that occurs mainly after anatomical and / or functional loss of small intestine and presents with diarrhea, steatorrhea, weight loss, malnutrition, malabsorption, dehydration. Therefore, appropriate nutritional therapy should be planned, and lost fluid and electrolytes should be replaced. A nutritional plan should be drawn up considering other factors affecting the disease and the type of surgical procedure. The main goal of treatment in short bowel syndrome is to achieve bowel adaptation. Nutritional interventions such as glutamine, growth hormone, fish oil and probiotics-prebiotics have recently been investigated for intestinal adaptation. The aim of this review is to examine medical nutrition therapy in short bowel syndrome and nutritional interventions in bowel adaptation.

References

  • 1. Pironi L, Arends J, Baxter J, Bozzetti F, Peláez RB, Cuerda C, et al. ESPEN endorsed recommendations. Definition and classification of intestinal failure in adults. Clinical Nutrition 2015;34(2):171 80.
  • 2. Pironi L, Arends J, Bozzetti F, Cuerda C, Gillanders L, Jeppesen PB, et al. ESPEN guidelines on chronic intestinal failure in adults. Clinical Nutrition 2016;35(2):247-307.
  • 3. Byrne TA, Nompleggi DJ, Wilmore DW. Advances in the management of patients with intestinal failure. Transplantation Proceedings 1996;28(5):2683-90.
  • 4. Sundaram A, Koutkia P, Apovian CM. Nutritional management of short bowel syndrome in adults. J Clin Gastroenterol 2002;34 (3):207-20.
  • 5. Nightingale J, Woodward JM. Guidelines for management of patients with a short bowel. Gut 2006;55(4):1-12.
  • 6. Thompson JS. Inflammatory disease and outcome of short bowel syndrome. The American Journal of Surgery 2000;180(6):551-4.
  • 7. Buchman AL, Scolapio J, Fryer J. AGA technical review on short bowel syndrome and intestinal transplantation. Gastroenterology 2003;124(4):1111-34.
  • 8. DiBaise JK, Young RJ, Vanderhoof JA. Intestinal rehabilitation and the short bowel syndrome: Part 1. Am J Gastroenterol 2004;99(7):1386-95.
  • 9. Jeejeebhoy KN. Short bowel syndrome: a nutritional and medical approach. Canadian Medical Association Journal 2002;166(10):1297-302.
  • 10. Matarese LE, Steiger E. Dietary and medical management of short bowel syndrome in adult patients. Journal of Clinical Gastroenterology 2006;40(2):85-93.
  • 11. O'Connor TP, Lam MM, Diamond J. Magnitude of functional adaptation after intestinal resection. American Journal of Physiology 1999;276(5):1265-75.
  • 12. Baysal A. Glutamin: Bağışıklık ve Travmalı Hastalarda Yararları. Beslenme ve Diyet Dergisi 2001:30(1):1-3.
  • 13. Scolapio JS, McGreevy K, Tennyson GS, Burnett OL. Effect of glutamine in short-bowel syndrome. Clinical Nutrition 2001;20(4):319-23.
  • 14. Tekin A, Yemiş M, Küçükkartallar T, Vatansever C, Çakır M, Yılmaz H, et al. The effects of oral liquid and intravenous glutamine on bowel adaptation in a rabbit short bowel syndrome model. Turkish Journal of Gastroenterology 2010;21(3): 236-43.
  • 15. Byrne TA, Wilmore DW, Iyer K, Dibaise J, Clancy K, Robinson MK, et al. Growth hormone, glutamine, and an optimal diet reduces parenteral nutrition in patients with short bowel syndrome: a prospective, randomized, placebo-controlled, double-blind clinical trial. Annals of Surgery 2005;242(5):655-61.
  • 16. Guo M, Li Y, Li J. Effect of growth hormone, glutamine, and enteral nutrition on intestinal adaptation in patients with short bowel syndrome. Turkish Journal of Gastroenterology 2013;24(6):463-8.
  • 17. Szkudlarek J, Jeppesen PB, Mortensen PB. Effect of high dose growth hormone with glutamine and no change in diet on intestinal absorption in short bowel patients: a randomised, double blind, crossover, placebo-controlled study. Gut 2000;47(2):199-205.
  • 18. Diamond IR, Sterescu A, Pencharz PB, Kim JH, Galler PW. Changing the paradigm: omegaven for the treatment of liver failure in pediatric short bowel syndrome. Journal of Pediatric Gastroenterology and Nutrition 2009;48(2):209-15.
  • 19. Sukhotnik I, Shany A, Bashenko Y, Hayari L, Chemodanov E, Mogilner J, et al. Parenteral but not enteral omega-3 fatty acids (Omegaven) modulate intestinal regrowth after massive small bowel resection in rats. Journal of Parenteral and Enteral Nutrition 2010;34(5):503-12.
  • 20. Yang Q, Kock ND. Effects of dietary fish oil on intestinal adaptation in 20-day-old weanling rats after massive ileocecal resection. Pediatric Research 2010;68(3):183-7.
  • 21. Onishi S, Kaji T, Machigashira S, Yamada W, Masuya R, Nakame, K, et al. The effect of intravenous lipid emulsions and mucosal adaptation following massive bowel resection. Journal of Pediatric Surgery 2018;58(12):2444-48.
  • 22. Tolga-Müftüoğlu MA, Civak T, Çetin S, Civak L, Güngör O, Sağlam A. Effects of probiotics on experimental short-bowel syndrome. The American Journal of Surgery 2011;202(4): 461-8.
  • 23. Kanamori Y, Sugiyama M, Hashizume K, Yuki N, Morotomi M, Tanaka R. Experience of long-term synbiotic therapy in seven short bowel patients with refractory enterocolitis. Journal of Pediatric Surgery 2004;39(11):1686-92.
  • 24. Kanamori Y, Hashizume K, Sugiyama M, Morotomi M, Yuki N. Combination therapy with Bifidobacterium breve, Lactobacillus casei, and galactooligosaccharides dramatically improved the intestinal function in a girl with short bowel syndrome: a novel synbiotics therapy for intestinal failure. Digestive Diseases and Sciences 2001;46(9):2010-6.
  • 25. Uchida K, Takahashi T, Inoue M, Morotomi M, Otake K, Nakazawa M, et al. Immunonutritional effects during synbiotics therapy in pediatric patients with short bowel syndrome’’. Pediatric Surgery International 2007;23(3):243-8.
  • 26. Sentongo TA, Cohran V, Korff S, Sullivan C, Iyer K, Zheng X. Intestinal permeability and effects of Lactobacillus rhamnosus therapy in children with short bowel syndrome. Journal of Pediatric Gastroenterology and Nutrition 2008;46(1):41-7.
  • 27. Aydoğan T, Türkay C. Kısa Barsak Sendromu’nda Nutrisyon. Güncel gastroenteroloji 2011;15(2):127-31.
  • 28. Tsai PM, Duggan C. Malabsorption syndromes: Nutritional Management. Encyclopedia of Human Nutrition 2013;3:136-42.
  • 29. Samour PQ, King K. Gastrointestinal Hastalıklar, Gülhan Samur. Kısa Bağırsak Sendromu, 1. Baskı. Ankara, Nobel Akademik Yayıncılık; 2016. p: 188-90.
  • 30. Ovesen L, Chu R, Howard L. The influence of dietary fat on jejunostomy output in patients with severe short bowel syndrome. The American Journal of Clinical Nutrition 1983;38(2):270-77.
  • 31. Woolf GM, Miller C, Kurian R, Jeejeebhoy KN. Diet for patients with a shortbowel: high fat or high carbohydrate? Gastroenterology 1983;84(4):823-28.
  • 32. Nordgaard I, Hansen BS, Mortensen PB. Colon as a digestive organ in patients with short bowel. Lancet 1994;343(8894):373-76.
  • 33. McNeil NI. The contribution of the large intestine to energy supplies in man. The American Journal of Clinical Nutrition 1984;39(2):338-42.
  • 34. Wall EA. An overview of short bowel syndrome management: adherence, adaptation, and practical recommendations. Journal of the Academy of Nutrition and Dietetics 2013;113(9):1200-8.
  • 35. Ilgaz Ş. Yanlış Beslenme Alışkanlıkları Şişmanlığa Yol Açar. Sürekli Tıp Eğitimi Dergisi 2002;11(4):301-2.
  • 36. Jeppesen PB, Mortensen PB. The influence of a preserved colon on the absorption of medium chain fat in patients with small bowel resection. Gut 1998;43(4):478-83.
  • 37. Matarese LE, O’Keefe SJ, Kandil HK, Bond G, Costa G, Abu-Elmagd K. Short-bowel syndrome: clinical guidelines for nutrition management. Nutrition in Clinical Practice 2005; 20(5):493-502.
  • 38. Okuda K. Discovery of vitamin B12 in the liver and its absorption factor in the stomach: a historical review. Journal of Gastroenterolgy and Hepatology 1999;14(4):301-8.
  • 39. Pironi L, Corcos O, Alastair F, Mette H, Francisca J, Jonkers, et al. Intestinal failure in adults: Recommendations from the ESPEN expert groups. Clinical Nutrition 2018;37: 1798-809.

KISA BAĞIRSAK SENDROMUNDA TIBBİ BESLENME TEDAVİSİ VE BAĞIRSAK ADAPTASYONUNDA BESİN MÜDAHALELERİ

Year 2021, Volume: 24 Issue: 2, 291 - 297, 25.06.2021
https://doi.org/10.17049/ataunihem.643472

Abstract

İnce bağırsağın 'normal' uzunluğu 320-800 cm arasında değişmektedir. İnce bağırsak uzunluğunun 200 cm'den daha az olması kısa bağırsak sendromu olarak tanımlanmaktadır. Kısa bağırsak sendromu, esas olarak ince bağırsağın anatomik ve/veya fonksiyonel kaybından sonra ortaya çıkan ve ishal, steatore, ağırlık kaybı, malnütriyon, malabsorbsiyon, dehidrasyon gibi bulgularla kendini gösteren klinik bir tablodur. Bu tablonun hafiflemesi için uygun beslenme tedavisi planlanmalı, kaybedilen sıvı ve elektrolitler yerine konulmalıdır. Hastalığın altında yatan faktörler ve cerrahi işlem türü dikkate alınarak beslenme planı oluşturulmalıdır. Kısa bağırsak sendromunda tedavinin en temel hedefi bağırsak adaptasyonunun sağlanmasıdır. Bağırsak adaptasyonu için son zamanlarda glutamin, büyüme hormonu, balık yağı ve probiyotikler-prebiyotikler gibi besin müdahaleleri araştırılmaktadır. Bu derlemenin amacı kısa bağırsak sendromunda tıbbi beslenme tedavisini ve bağırsak adaptasyonunda besin müdahalelerini incelemektir. 

References

  • 1. Pironi L, Arends J, Baxter J, Bozzetti F, Peláez RB, Cuerda C, et al. ESPEN endorsed recommendations. Definition and classification of intestinal failure in adults. Clinical Nutrition 2015;34(2):171 80.
  • 2. Pironi L, Arends J, Bozzetti F, Cuerda C, Gillanders L, Jeppesen PB, et al. ESPEN guidelines on chronic intestinal failure in adults. Clinical Nutrition 2016;35(2):247-307.
  • 3. Byrne TA, Nompleggi DJ, Wilmore DW. Advances in the management of patients with intestinal failure. Transplantation Proceedings 1996;28(5):2683-90.
  • 4. Sundaram A, Koutkia P, Apovian CM. Nutritional management of short bowel syndrome in adults. J Clin Gastroenterol 2002;34 (3):207-20.
  • 5. Nightingale J, Woodward JM. Guidelines for management of patients with a short bowel. Gut 2006;55(4):1-12.
  • 6. Thompson JS. Inflammatory disease and outcome of short bowel syndrome. The American Journal of Surgery 2000;180(6):551-4.
  • 7. Buchman AL, Scolapio J, Fryer J. AGA technical review on short bowel syndrome and intestinal transplantation. Gastroenterology 2003;124(4):1111-34.
  • 8. DiBaise JK, Young RJ, Vanderhoof JA. Intestinal rehabilitation and the short bowel syndrome: Part 1. Am J Gastroenterol 2004;99(7):1386-95.
  • 9. Jeejeebhoy KN. Short bowel syndrome: a nutritional and medical approach. Canadian Medical Association Journal 2002;166(10):1297-302.
  • 10. Matarese LE, Steiger E. Dietary and medical management of short bowel syndrome in adult patients. Journal of Clinical Gastroenterology 2006;40(2):85-93.
  • 11. O'Connor TP, Lam MM, Diamond J. Magnitude of functional adaptation after intestinal resection. American Journal of Physiology 1999;276(5):1265-75.
  • 12. Baysal A. Glutamin: Bağışıklık ve Travmalı Hastalarda Yararları. Beslenme ve Diyet Dergisi 2001:30(1):1-3.
  • 13. Scolapio JS, McGreevy K, Tennyson GS, Burnett OL. Effect of glutamine in short-bowel syndrome. Clinical Nutrition 2001;20(4):319-23.
  • 14. Tekin A, Yemiş M, Küçükkartallar T, Vatansever C, Çakır M, Yılmaz H, et al. The effects of oral liquid and intravenous glutamine on bowel adaptation in a rabbit short bowel syndrome model. Turkish Journal of Gastroenterology 2010;21(3): 236-43.
  • 15. Byrne TA, Wilmore DW, Iyer K, Dibaise J, Clancy K, Robinson MK, et al. Growth hormone, glutamine, and an optimal diet reduces parenteral nutrition in patients with short bowel syndrome: a prospective, randomized, placebo-controlled, double-blind clinical trial. Annals of Surgery 2005;242(5):655-61.
  • 16. Guo M, Li Y, Li J. Effect of growth hormone, glutamine, and enteral nutrition on intestinal adaptation in patients with short bowel syndrome. Turkish Journal of Gastroenterology 2013;24(6):463-8.
  • 17. Szkudlarek J, Jeppesen PB, Mortensen PB. Effect of high dose growth hormone with glutamine and no change in diet on intestinal absorption in short bowel patients: a randomised, double blind, crossover, placebo-controlled study. Gut 2000;47(2):199-205.
  • 18. Diamond IR, Sterescu A, Pencharz PB, Kim JH, Galler PW. Changing the paradigm: omegaven for the treatment of liver failure in pediatric short bowel syndrome. Journal of Pediatric Gastroenterology and Nutrition 2009;48(2):209-15.
  • 19. Sukhotnik I, Shany A, Bashenko Y, Hayari L, Chemodanov E, Mogilner J, et al. Parenteral but not enteral omega-3 fatty acids (Omegaven) modulate intestinal regrowth after massive small bowel resection in rats. Journal of Parenteral and Enteral Nutrition 2010;34(5):503-12.
  • 20. Yang Q, Kock ND. Effects of dietary fish oil on intestinal adaptation in 20-day-old weanling rats after massive ileocecal resection. Pediatric Research 2010;68(3):183-7.
  • 21. Onishi S, Kaji T, Machigashira S, Yamada W, Masuya R, Nakame, K, et al. The effect of intravenous lipid emulsions and mucosal adaptation following massive bowel resection. Journal of Pediatric Surgery 2018;58(12):2444-48.
  • 22. Tolga-Müftüoğlu MA, Civak T, Çetin S, Civak L, Güngör O, Sağlam A. Effects of probiotics on experimental short-bowel syndrome. The American Journal of Surgery 2011;202(4): 461-8.
  • 23. Kanamori Y, Sugiyama M, Hashizume K, Yuki N, Morotomi M, Tanaka R. Experience of long-term synbiotic therapy in seven short bowel patients with refractory enterocolitis. Journal of Pediatric Surgery 2004;39(11):1686-92.
  • 24. Kanamori Y, Hashizume K, Sugiyama M, Morotomi M, Yuki N. Combination therapy with Bifidobacterium breve, Lactobacillus casei, and galactooligosaccharides dramatically improved the intestinal function in a girl with short bowel syndrome: a novel synbiotics therapy for intestinal failure. Digestive Diseases and Sciences 2001;46(9):2010-6.
  • 25. Uchida K, Takahashi T, Inoue M, Morotomi M, Otake K, Nakazawa M, et al. Immunonutritional effects during synbiotics therapy in pediatric patients with short bowel syndrome’’. Pediatric Surgery International 2007;23(3):243-8.
  • 26. Sentongo TA, Cohran V, Korff S, Sullivan C, Iyer K, Zheng X. Intestinal permeability and effects of Lactobacillus rhamnosus therapy in children with short bowel syndrome. Journal of Pediatric Gastroenterology and Nutrition 2008;46(1):41-7.
  • 27. Aydoğan T, Türkay C. Kısa Barsak Sendromu’nda Nutrisyon. Güncel gastroenteroloji 2011;15(2):127-31.
  • 28. Tsai PM, Duggan C. Malabsorption syndromes: Nutritional Management. Encyclopedia of Human Nutrition 2013;3:136-42.
  • 29. Samour PQ, King K. Gastrointestinal Hastalıklar, Gülhan Samur. Kısa Bağırsak Sendromu, 1. Baskı. Ankara, Nobel Akademik Yayıncılık; 2016. p: 188-90.
  • 30. Ovesen L, Chu R, Howard L. The influence of dietary fat on jejunostomy output in patients with severe short bowel syndrome. The American Journal of Clinical Nutrition 1983;38(2):270-77.
  • 31. Woolf GM, Miller C, Kurian R, Jeejeebhoy KN. Diet for patients with a shortbowel: high fat or high carbohydrate? Gastroenterology 1983;84(4):823-28.
  • 32. Nordgaard I, Hansen BS, Mortensen PB. Colon as a digestive organ in patients with short bowel. Lancet 1994;343(8894):373-76.
  • 33. McNeil NI. The contribution of the large intestine to energy supplies in man. The American Journal of Clinical Nutrition 1984;39(2):338-42.
  • 34. Wall EA. An overview of short bowel syndrome management: adherence, adaptation, and practical recommendations. Journal of the Academy of Nutrition and Dietetics 2013;113(9):1200-8.
  • 35. Ilgaz Ş. Yanlış Beslenme Alışkanlıkları Şişmanlığa Yol Açar. Sürekli Tıp Eğitimi Dergisi 2002;11(4):301-2.
  • 36. Jeppesen PB, Mortensen PB. The influence of a preserved colon on the absorption of medium chain fat in patients with small bowel resection. Gut 1998;43(4):478-83.
  • 37. Matarese LE, O’Keefe SJ, Kandil HK, Bond G, Costa G, Abu-Elmagd K. Short-bowel syndrome: clinical guidelines for nutrition management. Nutrition in Clinical Practice 2005; 20(5):493-502.
  • 38. Okuda K. Discovery of vitamin B12 in the liver and its absorption factor in the stomach: a historical review. Journal of Gastroenterolgy and Hepatology 1999;14(4):301-8.
  • 39. Pironi L, Corcos O, Alastair F, Mette H, Francisca J, Jonkers, et al. Intestinal failure in adults: Recommendations from the ESPEN expert groups. Clinical Nutrition 2018;37: 1798-809.
There are 39 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Review
Authors

Ebru Koptagel 0000-0001-8238-4455

Hülya Kamarlı Altun 0000-0001-9878-9297

Publication Date June 25, 2021
Submission Date November 6, 2019
Published in Issue Year 2021 Volume: 24 Issue: 2

Cite

Vancouver Koptagel E, Kamarlı Altun H. KISA BAĞIRSAK SENDROMUNDA TIBBİ BESLENME TEDAVİSİ VE BAĞIRSAK ADAPTASYONUNDA BESİN MÜDAHALELERİ. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi. 2021;24(2):291-7.

Journal is listed in the EBSCO CINAHL Database since 2019.

Journal of Anatolian Nursing and Health Sciences is licensed under a Creative Commons Attribution-NonCommercial 4.0 (CC BY-NC 4.0)

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