Predictors of Intestinal Adaptation in Children

Gastroenterol Clin North Am. 2019 Dec;48(4):499-511. doi: 10.1016/j.gtc.2019.08.004. Epub 2019 Oct 4.

Abstract

In children, short-bowel syndrome (SBS) accounts for two-thirds of the cases of intestinal failure, and motility disorders and congenital mucosal diarrheal disorders account for the remaining one-third. Children with SBS are supported primarily by parenteral nutrition, which is the single-most important therapy contributing to their improved prognosis. More than 90% of children with SBS who are cared for at experienced intestinal rehabilitation programs survive, and roughly 60% to 70% undergo intestinal adaptation and achieve full enteral autonomy. This article focuses on the predictors of pediatric intestinal adaptation and discusses the pathophysiology and clinical management of children with SBS.

Keywords: Enteral autonomy; Intestinal adaptation; Parenteral nutrition; Predictors; Short-bowel syndrome.

Publication types

  • Review

MeSH terms

  • Adaptation, Physiological / physiology*
  • Bacteremia / etiology
  • Bacteremia / prevention & control
  • Biomarkers / metabolism
  • Catheterization, Central Venous / adverse effects
  • Child
  • Citrulline / metabolism
  • Enteral Nutrition
  • Gastrointestinal Agents / therapeutic use
  • Humans
  • Liver Diseases / etiology
  • Liver Diseases / prevention & control
  • Parenteral Nutrition
  • Peptides / therapeutic use
  • Prognosis
  • Short Bowel Syndrome / etiology
  • Short Bowel Syndrome / physiopathology
  • Short Bowel Syndrome / therapy*

Substances

  • Biomarkers
  • Gastrointestinal Agents
  • Peptides
  • Citrulline
  • teduglutide