Evidence-based recommendations of the Andalusian Group for Nutrition Reflection and Investigation (GARIN) for the management of adult patients with short bowel syndrome.

Abstract

INTRODUCTION:

In order to develop evidence-based recommendations and expert consensus for the nutritional management of patients with short bowel syndrome (SBS), we conducted a systematic literature search using the PRISMA methodology plus a critical appraisal following the GRADE scale procedures. Pharmacological treatment with antisecretory drugs, antidiarrheal drugs, and somatostatin contributes to reducing intestinal losses. Nutritional support is based on parenteral nutrition; however, oral intake and/or enteral nutrition should be introduced as soon as possible. In the chronic phase, the diet should have as few restrictions as possible, and be adapted to the SBS type. Home parenteral nutrition (HPN) should be individualized. Single-lumen catheters are recommended and taurolidine should be used for locking the catheter. The HPN's lipid content must be greater than 1 g/kg per week but not exceed 1 g/kg per day, and omega-6 fatty acids (ω6 FAs) should be reduced. Trace element vials with low doses of manganese should be used. Patients with chronic SBS who require long-term HPN/fluid therapy despite optimized treatment should be considered for teduglutide treatment. All patients require a multidisciplinary approach and specialized follow-up. These recommendations and suggestions regarding nutritional management in SBS patients have direct clinical applicability.

• Authors: Francisco J Vílchez-López, Laura Larrán-Escandón, José M García Almeida, Carmen Arraiza Irigoyen, José A Irles Rocamora, María J Molina-Puerta, Juan B Molina Soria, José Luis Pereira Cunill, Juana M Rabat Restrepo, María I Rebollo-Pérez, María P Serrano Aguayo, Carmen Tenorio-Jiménez, Gabriel Olveira, Pedro P García Luna
• Journal: Nutricion hospitalaria (Nutr Hosp) Vol. 38 Issue 6 Pg. 1287-1303 (Dec 09 2021) ISSN: 1699-5198 [Electronic] Spain
• Vernacular Title: Recomendaciones basadas en la evidencia del Grupo Andaluz para la Reflexión e Investigación en Nutrición (GARIN) para el manejo del paciente con síndrome de intestino corto.
• PMID: 34448398 (Publication Type: Journal Article)

Topics

• Adult
• Consensus
• Evidence-Based Practice (methods)
• Humans
• Parenteral Nutrition (methods, standards, trends)
• Short Bowel Syndrome (diet therapy)