title: 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 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.
authors.affiliation: Section of Pediatric Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI 48109-0245, USA.
authors.forename: Eiichi A
authors.initials: EA
authors.lastname: Miyasaka
authors.forename: Pamela I
authors.initials: PI
authors.lastname: Brown
authors.forename: Shirley
authors.initials: S
authors.lastname: Kadoura
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Harris
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Teitelbaum
mesh_terms: D000293:Adolescent; D002648:Child; D019587:Dietary Supplements; D005183:Failure to Thrive / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D010288:Parenteral Nutrition / Q000379:methods*; D012189:Retrospective Studies; D055502:Secondary Prevention; D012778:Short Bowel Syndrome / Q000150:complications* / Q000628:therapy; D016896:Treatment Outcome