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Nutrition in Clinical Practice
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Invited Reviews

Short Bowel Syndrome: Clinical Guidelines for Nutrition Management

Laura E. Matarese, MS, RD, LDN, FADA, CNSD*
Stephen J. O'Keefe, MD, MSc, FRCP{dagger}
Hossam M. Kandil, MD, PhD{dagger}
Geoffrey Bond, MD*
Guilherme Costa, MD*
Kareem Abu-Elmagd, MD, PhD, FACS*

* Intestinal Rehabilitation and Transplant Center, Thomas E. Starzl Transplantation Institute, and the{dagger} Department of Gastroenterology, The University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania

Correspondence: Correspondence: Laura E. Matarese, MS, RD, LDN, FADA, CNSD, Director of Nutrition, Intestinal Rehabilitation and Transplant Center, Thomas E. Starzl Transplantation Institute, UPMC Montefiore, 7 South, 3459 Fifth Avenue, Pittsburgh, PA 15213. Electronic mail may be sent to mataresele{at}upmc.edu.

Intestinal failure is a condition in which inadequate digestion or absorption of fluid, electrolytes, and nutrients leads to dehydration or malnutrition. The most common cause of intestinal failure is short bowel syndrome (SBS) defined as <200 cm of functional small intestine. SBS may result from congenital abnormalities or from surgical resection. For the past 3 decades, patients with severe SBS were managed with home parenteral nutrition (HPN). With the emergence of new therapies, the clinician now has multiple options to treat these patients. These include intestinal rehabilitation regimens whereby patients are treated with specialized oral diets, soluble fiber, oral rehydration solutions (ORS), and trophic factors to enhance absorption. There are also a variety of surgical techniques available to preserve intestinal length. Small bowel and multivisceral transplantation has evolved during the last decade to be a valid therapeutic option for those patients who cannot be rehabilitated or who fail HPN. These are interrelated services designed to offer the patient the best therapeutic options to meet their individual needs. This article reviews the principles associated with the nutrition management of this very complex and diverse group of patients.

Nutrition in Clinical Practice, Vol. 20, No. 5, 493-502 (2005)
DOI: 10.1177/0115426505020005493
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Related articles in Nutrition in Clinical Practice:

Practical Guide to Intestinal Rehabilitation for Postresection Intestinal Failure: A Case Study
Laura E. Matarese, Douglas L. Seidner, Ezra Steiger, and Victor Fazio
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