The adolescent child with short bowel syndrome: new onset of failure to thrive and need for increased nutritional supplementation

Abstract Background Proper nutrition for children with short bowel syndrome (SBS) is challenging. An underappreciated SBS cohort is the group of adolescents in which nutritional demand is markedly increased. We identified several children that previously had weaned off parenteral nutrition but neede...

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Bibliographic Details
Published in:Journal of pediatric surgery 2010-06, Vol.45 (6), p.1280-1286
Main Authors: Miyasaka, Eiichi A, Brown, Pamela I, Kadoura, Shirley, Harris, Mary Beth, Teitelbaum, Daniel H
Format: Article
Language:English
Subjects:
Adolescence
Adolescent
Child
Dietary Supplements
Failure to Thrive - epidemiology
Failure to Thrive - etiology
Failure to Thrive - therapy
Female
Follow-Up Studies
Humans
Incidence
Male
Nutrition
Parenteral Nutrition - methods
Pediatrics
Retrospective Studies
Secondary Prevention
Short bowel syndrome
Short Bowel Syndrome - complications
Short Bowel Syndrome - therapy
Surgery
Treatment Outcome
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Summary:Abstract Background Proper nutrition for children with short bowel syndrome (SBS) is challenging. An underappreciated SBS cohort is the group of adolescents in which nutritional demand is markedly increased. We identified several children that previously had weaned off parenteral nutrition but needed re-initiation of parenteral nutrition or increased enteral nutritional supplementation (NS) during adolescence. This study aims to identify characteristics of adolescent SBS patients to better understand their nutritional status. Methods A single institution, retrospective review of SBS patients over 10 years was done. Patients were analyzed for NS need, remaining bowel length, height, weight, and essential nutrient levels. Results Sixteen adolescent SBS patients were identified for analysis. Of these, ten did not require increased NS upon reaching adolescence (group A), and six required increased NS during adolescence (group B). Group B patients required a mean increase in NS of 29.6 kcal/kg per day. Group B patients had significantly shorter remaining bowel length. NS resulted in minimal height increase, but more substantial gains in weight and pubertal development. Conclusions Adolescents with SBS may require NS beyond what can be provided enterally. These patients are at risk for nutritional deficiencies, and an aggressive approach to monitoring and supplementing these deficiencies is warranted, especially during this critical period of growth.
ISSN:0022-3468
1531-5037
DOI:10.1016/j.jpedsurg.2010.02.100