Short bowel syndrome in children and adults: from rehabilitation to transplantation

Expert Review of Gastroenterology & Hepatology
Augusto Lauro, Florence Lacaille

Abstract

Short bowel syndrome (SBS) is a dramatic clinical condition in both children and adults; the residual bowel length is not sufficient to avoid intestinal failure, with subsequent malnutrition and growth retardation, and intravenous support is required to provide the nutrients normally coming from the intestine. Apart from the primary disease, the medical status can be worsened by complications of intestinal failure: if there are irreversible, the prognosis is poor unless a successful intestinal rehabilitation is achieved. Areas covered: The rescue of the remnant small bowel requires a multidisciplinary expertise to achieve digestive autonomy. The use of intestinal trophic factors has shown encouraging results in improving the intestinal adaptation process. Whenever the residual bowel length is inadequate, in a well-selected population weaning parenteral nutrition (PN) off could be attempted by surgery through lengthening procedures. A further subset of patients, with total and irreversible intestinal failure and severe complications on PN, may have an indication to intestinal transplantation. This procedure is still affected by poor long-term results. Expert commentary: Novel approaches developed through a multidisciplinary team...Continue Reading

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Citations

Feb 20, 2020·Current Opinion in Organ Transplantation·Mathias ClarysseJacques Pirenne
Jun 17, 2020·Archives of Iranian Medicine·Hamed NikoupoorSaman Nikeghbalian
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Oct 1, 2021·Transplantation·María Virginia GentiliniGabriel E Gondolesi

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