title: Neonatal short bowel syndrome as a model of intestinal failure: physiological background for enteral feeding.
abstract: Intestinal failure (IF) is a well identified clinical condition, which is characterised by the reduction of functional gut capacity below the minimum needed for adequate digestion and absorption of nutrients for normal growth in children. Short bowel syndrome (SBS) is the leading cause of IF in neonates, infants and young children usually as a result of extensive intestinal resection during the neonatal period. Simultaneously maintaining optimal nutritional status and achieving intestinal adaptation is a clinical challenge in short bowel patients. Both growth and development of the child as well as gut adaptation should be considered synergistically as primary outcome parameters. Enteral nutrition (EN) can be introduced orally and/or by tube feeding (TF). Several controversies over nutritional treatment of children with SBS related intestinal failure remain. As reported from different centres around the world, most practices are more "experienced based" rather than "evidence based". This is partly due to the small number of patients with this condition. This review (based on a consensus) discusses the physiological principles and nutritional management, including the type of diet and route of delivery. Perspectives in optimizing intestinal adaptation and reducing the consequences of small intestinal bacterial overgrowth are also discussed.
authors.affiliation: Department of Pediatric Gastroenterology-Hepatology and Nutrition, Reference Center for Rare Digestive Diseases, Intestinal Failure Rehabilitation Center, Hôpital Necker-Enfants Malades, University of Paris Descartes, France. Olivier.goulet@nck.aphp.fr
authors.forename: O
authors.initials: O
authors.lastname: Goulet
authors.forename: J
authors.initials: J
authors.lastname: Olieman
authors.forename: J
authors.initials: J
authors.lastname: Ksiazyk
authors.forename: J
authors.initials: J
authors.lastname: Spolidoro
authors.forename: D
authors.initials: D
authors.lastname: Tibboe
authors.forename: H
authors.initials: H
authors.lastname: Köhler
authors.forename: R Vural
authors.initials: RV
authors.lastname: Yagci
authors.forename: J
authors.initials: J
authors.lastname: Falconer
authors.forename: G
authors.initials: G
authors.lastname: Grimble
authors.forename: R M
authors.initials: RM
authors.lastname: Beattie
mesh_terms: D000222:Adaptation, Physiological; D002675:Child, Preschool; D004032:Diet; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004041:Dietary Fats / Q000008:administration & dosage; D004043:Dietary Fiber / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D004750:Enteral Nutrition; D005231:Fatty Acids, Unsaturated / Q000008:administration & dosage; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007421:Intestine, Small / Q000503:physiopathology*; D009752:Nutritional Status; D019936:Probiotics / Q000008:administration & dosage; D012778:Short Bowel Syndrome / Q000178:diet therapy* / Q000503:physiopathology*
chemical_list: D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004043:Dietary Fiber; D004044:Dietary Proteins; D005231:Fatty Acids, Unsaturated