GASTROENTEROLOGY ARTICLE OF THE WEEK
January 27, 2005
DiBaise JK, Young RJ, Vanderhoof JA. Intestinal rehabilitation and the short bowel syndrome – Part 2. Am J Gastroenterol 2004;99:1823-1832.
1. Dietary management of short bowel syndrome
a. A high carbohydrate diet is preferred for patients who have a colon
b. A low carbohydrate diet is better for those with an ostomy and no colon, to minimize ostomy output
c. Medium chain triglyceride supplementation is not helpful if the colon is absent
d. Oxalate intake should be restricted in all SBS patients, regardless of the presence or absence of colon
e. Patients with a colon are not limited to the use of oral rehydration solution for fluid intake.
f. Hyperosmolar fluids can be consumed by those with a colon in place
g. Restrict fat to 10%-30% of total calories only in patients with a colon
True or False
2. The benefits of glutamine supplementation in patients with short bowel syndrome receiving enteral feedings is controversial.
3. Pancreatic enzyme supplementation is not helpful in the management of SBS patients.
4. Octreotide is not particularly helpful in the management of SBS, even in secretors
5. High doses of Loperamide are often needed due to disrupted enterohepatic circulation in SBS patients
6. Patients with a colon in place and diarrhea after resection of 150cm of ileum and some jejunum may benefit from cholestyramine therapy
7. A high fasting level of plasma citrulline may in some cases select patients who may be successfully weaned off TPN.