Cyclic parenteral nutrition does not change the intestinal microbiota in patients with short bowel syndrome

Furtado, Eduarda de Castro; Marchini, Júlio Sérgio; Fonseca, Carol Kobori da; Coelho, P. S. R.; Menegueti, Mayra Gonçalves; Auxiliadora‐Martins, Maria; Basile-Filho, Aníbal; Suen, Vívian Marques Miguel

doi:10.1590/s0102-86502013001300006

Cited by 7 publications

(4 citation statements)

References 26 publications

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“…Characterization of the intestinal microbiota in SBS has been limited, mostly involving adult patients [15, 16]. Early work in an animal model of SBS found significant dysbiosis of the gut microbiota following bowel resection with decreased colonic microbial diversity [17].…”

Section: Introductionmentioning

confidence: 99%

The bacterial communities of the small intestine and stool in children with short bowel syndrome

Zeichner¹,

Mongodin²,

Hittle³

et al. 2019

PLoS ONE

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Short bowel syndrome (SBS) presents an increasing problem in pediatrics. SBS often results from surgical resection of necrotic bowel following necrotizing enterocolitis or treatment of anatomic gastrointestinal defects. SBS is associated with significant morbidity and mortality, and creates substantial burdens for patients, families, and the health system. Recent reports have demonstrated that the fecal microbiome of children with SBS is significantly different from healthy control and severe intestinal microbial imbalances is associated with poor growth. We hypothesized that children with SBS and adverse clinical features such as PN dependent, shorter bowel length and lack of ileocecal valve would demonstrate more gut dysbiosis compare with the SBS non-PN dependent. An improved understanding of SBS pathogenesis would enhance management and potentially suggest new interventions. We studied microbial communities of SBS and control non-SBS patients from the jejunum, obtained endoscopically or by ostomy aspiration, and stool. We enrolled SBS patients who did and did not require parenteral nutrition (PN), as a surrogate marker for the seriousness of their disease. We studied the microbiota using high-throughput DNA sequencing of 16S rRNA genes and statistical analyses. We found that microbial diversity was significantly greater in jejunal aspirate than in stool samples in SBS patients, unlike non-SBS patients; that SBS patients receiving enteral feeds had greater diversity, and that SBS patients on PN and enteral feeds had lower differences in diversity in jejunal vs. stool samples. We found a trend toward increased diversity in patients with an intact ileocecal valve, and found that certain taxa were more abundant in the certain sample types, and in SBS patients vs. non-SBS patients. SBS patients have lower microbial diversity, especially patients with more severe disease, patients requiring PN, and those lacking an ileocecal valve. SBS patients, particularly those with more complex characteristics, exhibit differences in their intestinal microbiota. Particular individual taxa were over- and under-represented in patients with more unfavorable disease. While diminished diversity and alterations in microbiota composition are likely consequences of SBS, future efforts aimed at increasing microbial diversity and interventions targeting specific microbiota characteristics might constitute a testable approach to ameliorate some clinical SBS clinical consequences.

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Section: Introductionmentioning

confidence: 99%

The bacterial communities of the small intestine and stool in children with short bowel syndrome

Zeichner¹,

Mongodin²,

Hittle³

et al. 2019

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…Gastrointestinal factors (underlying disease, anatomy, feeding tubes, motility), nutritional factors (type and mode of delivery), and pharmacological treatments (antibiotics, antiacid, and drugs affecting motility) are all implicated in microbiome modulation in SBS (116). Patients receiving cyclic PN seem to have a relatively normal intestinal bacterial species ratio (117). Microbiota alteration may promote inflammation and development of SIBO (118) and also be implicated in CRBSI and IFALD development (110,119), although it is not known whether the altered microbiome is a primary or secondary problem.…”

Section: Prevention and Treatment Of Sbs‐if Complications (Irrespecti...mentioning

confidence: 99%

Nutrition and Intestinal Rehabilitation of Children With Short Bowel Syndrome: A Position Paper of the ESPGHAN Committee on Nutrition. Part 2: Long-Term Follow-Up on Home Parenteral Nutrition

Norsa,

Goulet,

Alberti

et al. 2023

Journal of Pediatric Gastroenterology &Amp; Nutrition

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Short bowel syndrome (SBS) is the leading cause of intestinal failure (IF) in children. The preferred treatment for IF is parenteral nutrition which may be required until adulthood. The aim of this position paper is to review the available evidence on managing SBS and to provide practical guidance to clinicians dealing with this condition. All members of the Nutrition Committee of the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) contributed to this position paper. Some renowned experts in the field joined the team to guide with their expertise. A systematic literature search was performed from 2005 to May 2021 using PubMed, MEDLINE, and Cochrane Database of Systematic Reviews. In the absence of evidence, recommendations reflect the expert opinion of the authors. Literature on SBS mainly consists of retrospective single-center experience, thus most of the current papers and recommendations are based on expert opinion. All recommendations were voted on by the expert panel and reached >90% agreement. This second part of the position paper is dedicated to the long-term management of children with SBS-IF. The paper mainly focuses on how to achieve intestinal rehabilitation, treatment of complications, and on possible surgical and medical management to increase intestinal absorption.

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“…Few studies have defined changes in the SBS microbiome in human populations. [15,16,17,18,19,20,21,22,23 ▪ ] Although inclusion and sample sizes differ across these single-centre studies, several patterns may be noted. Alpha-diversity is significantly decreased in SBS, and intestinal failure compared to healthy controls [17,24–26], and relative abundance of Proteobacteria (40% versus 9%) [22,25–27] and Lactobacillus (80–90% vs. <1%) [17,22,25–29] may be significantly higher.…”

Section: Composition Of the Microbiota In Short Bowel Syndromementioning

confidence: 99%

Intestinal microbiome in short bowel syndrome: diagnostic and therapeutic opportunities

Chowdhury,

Hill,

Shah

et al. 2023

Current Opinion in Gastroenterology

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Purpose of review The intestinal microbiome plays a strong, complementary role in the development and integrity of the intestinal epithelium. This biology is crucial for intestinal adaptation, particularly after the mucosal insults that lead to short bowel syndrome (SBS). The purpose of this review is to discuss relationships between the intestinal microbiota and the physiology of intestinal adaptation. Recent findings We will address interactions between the intestinal microbiome and nutritional metabolism, factors leading to dysbiosis in SBS, and common compositional differences of the gut microbiome in SBS patients as compared to healthy controls. We will also discuss novel opportunities to expand diagnostic and therapeutic interventions in this population, by using our knowledge of the microbiome to manipulate luminal bacteria and study their resultant metabolites. As microbial therapeutics advance across so many fields of medicine, this review is timely in its advocacy for ongoing research that focuses on the SBS population. Our review will discuss 4 key areas: 1) physiology of the intestinal microbiome in SBS, 2) clinical and therapeutic insults that lead to a state of dysbiosis, 3) currently available evidence on microbiome-based approaches to SBS management, and 4) opportunities and innovations to inspire future research. Summary The clinical implications of this review are both current, and potential. Understanding how the microbiome impacts intestinal adaptation and host physiology may enhance our understanding of why we experience such clinical variability in SBS patients’ outcomes. This review may also expand clinicians’ understanding of what ‘personalized medicine’ can mean for this patient population, and how we may someday consider our nutritional, therapeutic, and prognostic recommendations based on our patients’ host, and microbial physiology.

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Cyclic parenteral nutrition does not change the intestinal microbiota in patients with short bowel syndrome

Cited by 7 publications

References 26 publications

The bacterial communities of the small intestine and stool in children with short bowel syndrome

The bacterial communities of the small intestine and stool in children with short bowel syndrome

Nutrition and Intestinal Rehabilitation of Children With Short Bowel Syndrome: A Position Paper of the ESPGHAN Committee on Nutrition. Part 2: Long-Term Follow-Up on Home Parenteral Nutrition

Intestinal microbiome in short bowel syndrome: diagnostic and therapeutic opportunities

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