Enhancing bowel adaptation in short bowel syndrome.
Malabsorption of both nonessential and essential nutrients, fluid, and electrolytes will, if not compensated for by increased intake, lead to diminished body stores and to subclinical and eventually clinical deficiencies. By definition, intestinal failure prevails when parenteral support is necessary to maintain nutritional equilibrium. After intestinal resection, adaptation, a progressive recovery from the malabsorptive disorder, may be seen. Research has focused on optimizing remnant intestinal function through dietary or pharmacologic interventions. In this review, factors responsible for the morphologic and functional changes in the adaptive processes are described. Results of clinical trials employing either growth hormone and glutamine or glucagon-like peptide-2 in short bowel patients are presented.
Jeppesen
Palle Bekker
PB
Department of Medicine CA-2121, Section of Gastroenterology, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. Bekker@dadlnet.dk
Mortensen
Per Brobech
PB
D000222:Adaptation, Physiological; D003082:Colectomy / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005973:Glutamine / Q000008:administration & dosage*; D013006:Growth Hormone / Q000008:administration & dosage*; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis / Q000601:surgery; D007421:Intestine, Small / Q000601:surgery; D008297:Male; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D012778:Short Bowel Syndrome / Q000188:drug therapy* / Q000503:physiopathology; D016896:Treatment Outcome
D005973:Glutamine; D013006:Growth Hormone