Nutrition in the Management of Short Bowel Syndrome and Intestinal Failure

Dear Colleagues,

Intestinal failure is a condition in which an inadequate absorptive surface area or dysfunctional absorptive surface results in inadequate absorption of nutrients to sustain life. Short bowel syndrome, of which there are many causes, is perhaps the most common etiology, although several relatively rare disorders may also result in intestinal failure. The combination of parenteral and enteral nutrition must therefore be utilized in the majority of these patients to provide adequate energy and nutritional substrates. In the case of short bowel syndrome, and in certain other disorders, stimulation of intestinal adaptation through a combination of careful use of enteral nutrition and occasionally trophic drugs becomes a major goal in long-term therapy. Complications, including primarily small bowel bacterial overgrowth, but also renal and hepatobiliary stones, catheter infections, and nutritional deficiency states, must be anticipated and treated appropriately. Here again, careful use of enteral and parenteral nutrition is often key to success. In the case of failure to establish adequate adaptation and persistent intestinal failure with life-threatening complications, intestinal transplantation is often considered. Here again, both pre-and postoperatively, the use of a combination of parenteral and enteral nutrition becomes a key component of therapy. Use of appropriate nutrition to prevent nutritional deficiency states, assistance in controlling inflammation, and avoiding complications is a science unto itself. The manuscripts in this Special Edition are focused on various aspects of the specialized use of parenteral and enteral nutrition in intestinal failure both before and after intestinal transplantation.

Dr. Jon A. Vanderhoof
Guest Editor

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