Rehabilitation therapy for short bowel syndrome.
OBJECTIVE
To investigate the effect of rehabilitation therapy for short bowel syndrome on patient nutritional status and intestinal adaptation.


METHODS
The rehabilitation therapy included enteral or parenteral nutrition, glutamine, recombinant human growth hormone and rehabilitative diet. From January 1997 to July 2000, twenty - seven patients with short bowel syndrome received the treatment. The average age of the patients was 38.5 +/- 19.3 years, and the length of residual small intestine ranged from 15 to 80 cm, with an average of 46.8 +/- 23.4 cm. The ileocecal valve was preserved in 14 cases, and the average time between the onset of short bowel syndrome and the rehabilitation therapy was 86 +/- 105 days.


RESULTS
After the treatment, nutritional status of the patients improved markedly, and intestinal absorptive capacity improved. Eight patients were followed up for more than 2 years, among whom 4 (50%) were weaned from total parenteral nutrition. Thirteen patients were followed up for more than 1 year, and 10 patients (76.9%) were weaned from total parenteral nutrition.


CONCLUSIONS
Rehabilitation therapy for short bowel syndrome can improve patient nutritional status effectively and promote intestinal adaptation, providing a new hope for these patients. The therapeutic effects are related to the length of the residual small intestine, patients age and duration between massive intestinal resection and start of the treatment. Early initiation of rehabilitation therapy promotes intestinal adaptation and increases patients ability to wean from total parenteral nutrition.
Department of General Surgery, Jinling Hospital, Clinical School of Nanjing University, Nanjing 210002, China. juwiming@yahoo.com.cn
Weiming
W
Zhu
Ning
N
Li
Jian'an
J
Ren
Jun
J
Gu
Jun
J
Jiang
Jieshou
J
Li
D000293:Adolescent; D000328:Adult; D000368:Aged; D001798:Blood Proteins / Q000378:metabolism; D001835:Body Weight; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007408:Intestinal Absorption; D008297:Male; D008875:Middle Aged; D012709:Serum Albumin / Q000378:metabolism; D012778:Short Bowel Syndrome / Q000534:rehabilitation*; D016896:Treatment Outcome
D001798:Blood Proteins; D006454:Hemoglobins; D012709:Serum Albumin