Novel Therapeutic Approaches for Mitigating Complications in Short Bowel Syndrome

Bettag, Jeffery; Po, Loren; Cunningham, Cassius; Tallam, Rahul; Kurashima, Kento; Nagarapu, Aakash; Hutchinson, Chelsea; Morfin, Sylvia; Nazzal, Mustafa; Lin, Chien‐Jung; Mathur, Amit K.; Aurora, Rajeev; Jain, Ajay K.

doi:10.3390/nu14214660

Cited by 5 publications

(4 citation statements)

References 121 publications

(135 reference statements)

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“…As previously noted, changes in microbiota can be adaptive and respond positively to assist in disease states such as SBS and lack of luminal nutrition or can be pathologic as a result of maladaptive change [17,63,64]. One question that remains key is the causal relationship between SBS and microbiota.…”

Section: Short Bowel Syndrome and Gut Microbiomementioning

confidence: 99%

“…Emerging data also supports the use of fecal microbiota transplant as a therapeutic strategy for SBS with varying success, though the data remains compelling [83,84]. Additionally, there is continued exploration of microbiome signatures as potential biomarkers of intestinal adaptation and as a driver of D-lactic acidosis [63,85,86].…”

Section: Therapeutic Approaches To the Microbiomementioning

confidence: 99%

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Gut Microbiota Modulation of Short Bowel Syndrome and the Gut–Brain Axis

Carter,

Bettag,

Morfin

et al. 2023

Nutrients

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Short bowel syndrome (SBS) is a condition that results from a reduction in the length of the intestine or its functional capacity. SBS patients can have significant side effects and complications, the etiology of which remains ill-defined. Thus, facilitating intestinal adaptation in SBS remains a major research focus. Emerging data supports the role of the gut microbiome in modulating disease progression. There has been ongoing debate on defining a “healthy” gut microbiome, which has led to many studies analyzing the bacterial composition and shifts that occur in gastrointestinal disease states such as SBS and the resulting systemic effects. In SBS, it has also been found that microbial shifts are highly variable and dependent on many factors, including the anatomical location of bowel resection, length, and structure of the remnant bowel, as well as associated small intestinal bacterial overgrowth (SIBO). Recent data also notes a bidirectional communication that occurs between enteric and central nervous systems called the gut–brain axis (GBA), which is regulated by the gut microbes. Ultimately, the role of the microbiome in disease states such as SBS have many clinical implications and warrant further investigation. The focus of this review is to characterize the role of the gut microbiota in short bowel syndrome and its impact on the GBA, as well as the therapeutic potential of altering the microbiome.

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Section: Short Bowel Syndrome and Gut Microbiomementioning

confidence: 99%

Section: Therapeutic Approaches To the Microbiomementioning

confidence: 99%

Gut Microbiota Modulation of Short Bowel Syndrome and the Gut–Brain Axis

Carter,

Bettag,

Morfin

et al. 2023

Nutrients

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“…So, threatening complications warranting the consideration of intestinal Tx include IAFLD, recurrent sepsis, and threatened loss of central venous access. Table 9 shows the revised criteria for placement on a waitlist for ITx, presuming that a multidisciplinary team will have assessed patients, explored rehabilitation options, and a state of permanent or life-limiting intestinal failure exists [ 17 , 91 , 176 , 177 , 178 , 179 , 180 ].…”

Section: Short Bowel Syndrome (Sbs)mentioning

confidence: 99%

Section: Intestinal Transplantation (Itx)mentioning

confidence: 99%

Metabolic and Nutritional Issues after Lower Digestive Tract Surgery: The Important Role of the Dietitian in a Multidisciplinary Setting

Utrilla Fornals,

Costas-Batlle,

Medlin

et al. 2024

Nutrients

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Many patients undergo small bowel and colon surgery for reasons related to malignancy, inflammatory bowel disease (IBD), mesenteric ischemia, and other benign conditions, including post-operative adhesions, hernias, trauma, volvulus, or diverticula. Some patients arrive in the operating theatre severely malnourished due to an underlying disease, while others develop complications (e.g., anastomotic leaks, abscesses, or strictures) that induce a systemic inflammatory response that can increase their energy and protein requirements. Finally, anatomical and functional changes resulting from surgery can affect either nutritional status due to malabsorption or nutritional support (NS) pathways. The dietitian providing NS to these patients needs to understand the pathophysiology underlying these sequelae and collaborate with other professionals, including surgeons, internists, nurses, and pharmacists. The aim of this review is to provide an overview of the nutritional and metabolic consequences of different types of lower gastrointestinal surgery and the role of the dietitian in providing comprehensive patient care. This article reviews the effects of small bowel resection on macronutrient and micronutrient absorption, the effects of colectomies (e.g., ileocolectomy, low anterior resection, abdominoperineal resection, and proctocolectomy) that require special dietary considerations, nutritional considerations specific to ostomized patients, and clinical practice guidelines for caregivers of patients who have undergone a surgery for local and systemic complications of IBD. Finally, we highlight the valuable contribution of the dietitian in the challenging management of short bowel syndrome and intestinal failure.

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