title: Low zinc status and absorption exist in infants with jejunostomies or ileostomies which persists after intestinal repair.
abstract: There is very little data regarding trace mineral nutrition in infants with small intestinal ostomies. Here we evaluated 14 infants with jejunal or ileal ostomies to measure their zinc absorption and retention and biochemical zinc and copper status. Zinc absorption was measured using a dual-tracer stable isotope technique at two different time points when possible. The first study was conducted when the subject was receiving maximal tolerated feeds enterally while the ostomy remained in place. A second study was performed as soon as feasible after full feeds were achieved after intestinal repair. We found biochemical evidence of deficiencies of both zinc and copper in infants with small intestinal ostomies at both time points. Fractional zinc absorption with an ostomy in place was 10.9% ± 5.3%. After reanastamosis, fractional zinc absorption was 9.4% ± 5.7%. Net zinc balance was negative prior to reanastamosis. In conclusion, our data demonstrate that infants with a jejunostomy or ileostomy are at high risk for zinc and copper deficiency before and after intestinal reanastamosis. Additional supplementation, especially of zinc, should be considered during this time period.
authors.affiliation: Black Hills Pediatrics & Neonatology, LLP, Rapid City, SD 57701, USA. ksbalay@gmail.com
authors.forename: Kimberly S
authors.initials: KS
authors.lastname: Balay
authors.forename: Keli M
authors.initials: KM
authors.lastname: Hawthorne
authors.forename: Penni D
authors.initials: PD
authors.lastname: Hicks
authors.forename: Zhensheng
authors.initials: Z
authors.lastname: Chen
authors.forename: Ian J
authors.initials: IJ
authors.lastname: Griffin
authors.forename: Steven A
authors.initials: SA
authors.lastname: Abrams
mesh_terms: D000042:Absorption; D061605:Administration, Intravenous; D003300:Copper / Q000097:blood / Q000172:deficiency / Q000493:pharmacokinetics; D003947:Diagnostic Techniques, Radioisotope; D019587:Dietary Supplements; D002149:Energy Intake; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D007081:Ileostomy; D007223:Infant; D007413:Intestinal Mucosa / Q000378:metabolism; D007422:Intestines / Q000601:surgery; D007582:Jejunostomy; D008297:Male; D009752:Nutritional Status; D014131:Trace Elements / Q000172:deficiency; D015032:Zinc / Q000097:blood* / Q000172:deficiency / Q000493:pharmacokinetics*
chemical_list: D014131:Trace Elements; D003300:Copper; D015032:Zinc
keywords: copper; ileostomy; jejunostomy; nutrient absorption; ostomy; zinc