Dietary and Parenteral Nutritional Management of Short Bowel Syndrome with Intestinal Failure in Adults

Résumé fourni par la source

Short bowel syndrome (SBS) is the leading cause of chronic intestinal failure in adults, arising when the residual small bowel can no longer absorb the macronutrients, water and electrolytes needed to sustain health without intravenous supplementation. Its management is, at its core, a nutritional problem. This review synthesises current evidence and guideline recommendations on the two pillars of that management: dietary (oral/enteral) therapy and parenteral nutritional support. We frame both around the two variables that dominate clinical behaviour, namely residual intestinal anatomy and the phase of intestinal adaptation, and translate them into anatomy-tailored dietary strategies, rational fluid and electrolyte replacement, micronutrient surveillance, and the composition, delivery and complications of (home) parenteral nutrition. We also position the pharmacological adjuncts, culminating in glucagon-like peptide-2 (GLP-2) analogues, within a stepwise strategy to reduce parenteral-support dependence. The goal throughout is a practical, physiology-anchored approach that maximises enteral autonomy and quality of life while preventing the metabolic, hepatic and catheter-related complications of long-term intravenous feeding.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.