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Original Article
- Multidisciplinary Intestinal Rehabilitation for Short Bowel Syndrome in Adults: Results in a Korean Intestinal Rehabilitation Team
- Sojeong Yoon, Sanghoon Lee, Hyo Jung Park, Hyun-Jung Kim, Jihye Yoon, Ja-Kyung Min, Jeong-Meen Seo
- J Clin Nutr 2018;10(2):45-50. Published online December 31, 2018
- DOI: https://doi.org/10.15747/jcn.2018.10.2.45
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Abstract
PDF
ePub Purpose:
Intense multidisciplinary team effort is required for the intestinal rehabilitation of patients afflicted with the short bowel syndrome (SBS). These include enteral and parenteral nutrition (PN) support, monitoring of complications related to treatment, and considering further medical or surgical options for intestinal adaptation.
Methods:
In the Intestinal Rehabilitation Team (IRT) at the Samsung Medical Center, we have experienced 20 cases of adult SBS requiring multidisciplinary intestinal rehabilitation. This study is a retrospective review of the collected medical records.
Results:
Of the 20 subjects treated, 12 patients were male and 8 patients were female. At the time of referral to the IRT, the mean age was 51.5 years, and the mean body weight was 50.1 kg, which was 90% of the usual body weight. The diseases or operative managements preceding massive bowel resection were malignancy in 11 cases, cardiac surgery in 2 cases, trauma in 2 cases and one case, each of tuberculosis, corrosive esophagitis, atrial fibrillation, simultaneous pancreas and kidney transplantation, and perforated appendicitis. Of these, there were 14 survivals and 6 mortalities. The fatalities were attributed to progression of disease, intestinal failure-associated liver disease, and sepsis (unrelated to intestinal failure) (2 cases each). Among the 14 surviving patients, 8 patients have been weaned off PN, whereas 6 are still dependent on PN (mean PN dependence 36%).
Conclusion:
This paper reports the results of multidisciplinary intestinal rehabilitation of adult short bowel patients treated at the Samsung Medical Center. Further studies are required to improve survival and enteral tolerance of these patients.
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Citations
Citations to this article as recorded by
- The Post-Discharge Caregiving Experiences of Mothers of Children with Intestinal Failure
Yunhyung Kim, Yeon Hee Kim, Jae Sim Jeong
Journal of Korean Association for Qualitative Research.2024; 9(1): 1. CrossRef - Intestinal Rehabilitation Program for Adult Patients with Intestinal Failure: A 20-Year Analysis of Outcomes in the Single-Center Experience at a Tertiary Hospital
Kyoung Moo Im, Jae Hee Chung
Digestive Diseases and Sciences.2024; 69(5): 1770. CrossRef - Vitamin D Deficiency is Prevalent in Short Bowel Syndrome Patients on Long-Term Parenteral Nutrition Support
SungHyo An, Sanghoon Lee, Hyun-Jung Kim, Hyo Jung Park, Jeong-Meen Seo
Journal of Clinical Nutrition.2021; 13(1): 12. CrossRef - Multidisciplinary Intestinal Rehabilitation in Children: Results from a Korean Intestinal Rehabilitation Team
Cheolgu Lee, Sanghoon Lee, Hyo Jung Park, Hyun-Jung Kim, Ja-Kyung Min, Jeong-Meen Seo
Advances in Pediatric Surgery.2020; 26(2): 61. CrossRef
- The Post-Discharge Caregiving Experiences of Mothers of Children with Intestinal Failure
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- 4 Crossref
Review Article
- Nutrition Therapy for Adult Intestinal Failure Patients
- Hyo Jung Park
- J Clin Nutr 2016;8(3):72-76. Published online December 31, 2016
- DOI: https://doi.org/10.15747/jcn.2016.8.3.72
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Abstract
PDFePub
Intestinal failure (IF) is a condition, in which the intestinal function or length remaining is below the minimum amount required for the absorption of sufficient nutrients and fluid to maintain normal life. The nutritional supply of IF depends on the anatomical site, length, and function of the remaining bowel. The goals of nutritional therapy for patients with IF are to achieve bowel adaptation to absorb nutrients sufficiently to live a healthy life with the current intestinal condition, and to promote the enteral autonomy to control nutrient digestion, absorption, excretion, and bowel movement. To stabilize and recover the patient’s nutrition condition after a huge bowel resection, the intestinal rehabilitation team (IRT) for individual nutritional therapy should be established. IRT carefully monitors the changes in body weight, medication use, patient’s symptoms, nutrient deficiency, hydration status, function of the remaining bowel, degree of bowel adaptation, adverse effects due to nutritional therapy, and enteral balance. To achieve intestinal adaptation and enteral autonomy through complicated and difficult nutritional intensive therapy in IF patients, it is essential to manage the patients through multidisciplinary collaboration involving physicians, pharmacists, dietitians, and nurses.
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Original Article
- Intestinal Rehabilitation after Extensive Bowel Resection in Post-Gastrectomy Patients
- Seung Rim Han, Sanghoon Lee, Chae-Youn Oh, Hyun-Jung Kim, Hyo Jung Park, Jun Ho Lee, Tae Sung Sohn, Jae Moon Bae, Jeong-Meen Seo
- Surg Metab Nutr 2015;6(2):33-37. Published online December 30, 2015
- DOI: https://doi.org/10.18858/smn.2015.6.2.33
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Abstract
PDFePub
Purpose:
Surgical complications requiring massive bowel resection after gastrectomy are rare. However, when such an event occurs the patient may develop short bowel syndrome and intestinal failure. We report our experience of intestinal rehabilitation in four post-gastrectomy patients.
Materials and Methods:
From January 2011 to June 2014, four cases of short bowel syndrome were identified in post-gastrectomy patients. All patients were managed by a multidisciplinary team specialized in the care of intestinal failure patients. Patients’ medical records were reviewed retrospectively.
Results:
The original diagnosis was early gastric cancer in all patients. One patient had synchronous esophageal cancer. Patients required extensive bowel resection due to bowel strangulation from internal herniation (3 cases), superior mesenteric artery torsion (1 case). Remnant small bowel length ranged from 10 cm to 80 cm and partial resection of the colon was performed in three cases. One patient received serial transverse enteroplasty (STEP) and one patient is receiving continuous enteral feeding via surgical gastrostomy. There were no cases of intestinal failure-associated liver disease. Two patients are receiving home parenteral nutrition in varying degrees. Two patients have been weaned off parenteral nutrition.
Conclusion:
Four post-gastrectomy patients with short bowel syndrome were managed. Despite application of various medical and surgical measures, weaning off parenteral nutrition was difficult in these patients.
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