| Theme |
Nutritional Managements for Maintenance Dialysis Patients with Clinical Complications |
| Title |
Nutritional management of short bowel syndrome |
| Author |
Toshio Nakamura |
The Second Department of Surgery, Hamamatsu University School of Medicine |
| Author |
Junko Nakayama |
The Department of Nutrition, Hamamatsu University School of Medicine |
| Author |
Kiyotaka Kurachi |
The Second Department of Surgery, Hamamatsu University School of Medicine |
| Author |
Hiroyuki Konno |
The Second Department of Surgery, Hamamatsu University School of Medicine |
| [ Summary ] |
Short bowel syndrome (SES) is a food malabsorption condition related to disease or the surgical removal of a large portion of the small intestine. The most common causes of SBS in adults include Crohn's disease, radiation enteritis, mesenteric vascular accidents, trauma, and recurrent intestinal obstruction. Patients undergoing massive small bowel resections frequently experience dehydration or electrolyte imbalances in the early postoperative period. The first priority is to ensure that the patient is adequately resuscitated and hemodynamically stable. The severity of the condition is determined by the amount of bowel removed, the age of the patient, and the length of the remaining small intestine, as well as the condition of the remaining bowel and digestive organs, as well as the presence or absence of the ileocecal valve and colon. Parenteral nutrition provides adequate protein, calories, other macronutrients, and micronutrients until the bowel has had time to adapt. When patients with SBS can not receive adequate enteral nutrition, they often require prolonged total parenteral nutrition. Currently to receive home-delivered total parenteral nutrition, an implanted port is necessary. Patients with SBS require lifetime care. Those on parenteral nutrition require frequent monitoring of serum chemistries ; liver function tests ; and vitamin, mineral, and trace element level assessment. |