Nutrition and Intestinal Rehabilitation of Children With Short Bowel Syndrome
Lorenzo Norsa, Olivier Goulet, Daniele Alberti, Barbara DeKooning, Magnus Domellöf, Nadja Haiden, Susan Hill, Flavia Indrio, Jutta Köglmeier, Alexandre Lapillonne, Verónica Luque, Sissel J. Moltu, Miguel Saenz De Pipaon, Francesco Savino, Elvira Verduci, Jiří Bronský
Abstract
Short bowel syndrome (SBS) is the leading cause of intestinal failure (IF) in children. The preferred treatment for IF is parenteral nutrition which may be required until adulthood. The aim of this position paper is to review the available evidence on managing SBS and to provide practical guidance to clinicians dealing with this condition. All members of the Nutrition Committee of the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) contributed to this position paper. Some renowned experts in the field joined the team to guide with their expertise. A systematic literature search was performed from 2005 to May 2021 using PubMed, MEDLINE, and Cochrane Database of Systematic Reviews. In the absence of evidence, recommendations reflect the expert opinion of the authors. Literature on SBS mainly consists of retrospective single-center experience, thus most of the current papers and recommendations are based on expert opinion. All recommendations were voted on by the expert panel and reached >90% agreement. This second part of the position paper is dedicated to the long-term management of children with SBS-IF. The paper mainly focuses on how to achieve intestinal rehabilitation, treatment of complications, and on possible surgical and medical management to increase intestinal absorption.