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J Acad Nutr Diet ; 113(9): 1200-8, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23830324

RESUMO

Short bowel syndrome (SBS) refers to the clinical consequences resulting from loss of small bowel absorptive surface area due to surgical resection or bypass. The syndrome is characterized by maldigestion, malabsorption, and malnutrition. Survival of patients with SBS is dependent on adaptation in the remaining bowel and a combination of pharmacologic and nutrition therapies. Individual plans of care are developed based on the length and sites of remaining bowel, the degree of intestinal adaptation, and the patient's ability to adhere to the medication and dietary regimens. Antisecretory and antidiarrheal medications are prescribed to slow intestinal transit times and optimize fluid and nutrient absorption. Based on postsurgical anatomy, enteral feedings, parenteral infusions, complex diet plans, and vitamin and mineral supplementation are used in various combinations to nourish patients with SBS. In the acute care setting, registered dietitians (RDs) assist with infusion therapy, diet education, and discharge planning. Long-term, as the small intestine adapts, RDs revise the nutrition care plan and monitor for nutrient deficiencies, metabolic bone disease, and anemia. The frequent monitoring and revision of care plans, plus the appreciable benefits from proper medical nutrition therapy, make this patient population extremely challenging and rewarding for RDs to manage. This article provides a brief, case study-based overview of the medical and nutrition management of SBS.


Assuntos
Síndrome do Intestino Curto/terapia , Adaptação Fisiológica , Idoso , Antidiarreicos/uso terapêutico , Suplementos Nutricionais , Doenças do Sistema Digestório/etiologia , Doenças do Sistema Digestório/terapia , Feminino , Humanos , Síndromes de Malabsorção/etiologia , Síndromes de Malabsorção/terapia , Desnutrição/etiologia , Desnutrição/terapia , Apoio Nutricional , Nutrição Parenteral , Cooperação do Paciente , Guias de Prática Clínica como Assunto , Síndrome do Intestino Curto/complicações , Síndrome do Intestino Curto/fisiopatologia
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