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Clin Nutr Res. 2017 Jul;6(3):221-228. doi: 10.7762/cnr.2017.6.3.221. Epub 2017 Jul 31.

Intensive Nutrition Management in a Patient with Short Bowel Syndrome Who Underwent Bariatric Surgery.

Kweon M1,2, Ju DL1,2, Park M1,2, Choe J2,3, Suh YS2,4,5, Seol EM2,6, Lee HJ2,4,5.

Author information

1
Department of Food Service and Nutrition Care,Seoul National University Hospital, Seoul 03080, Korea.
2
Nutritional Support Team,Seoul National University Hospital, Seoul 03080, Korea.
3
Department of Pharmacy,Seoul National University Hospital, Seoul 03080, Korea.
4
Division of Gastrointestinal Surgery,Department of Surgery,Seoul National University College of Medicine, Seoul 03080, Korea.
5
Cancer Research Institute, Seoul National University College of Medicine, Seoul 03080, Korea.
6
Department of Nursing Service,Seoul National University Hospital, Seoul 03080, Korea.

Abstract

Many individuals with short bowel syndrome (SBS) require long-term parenteral nutrition (PN) to maintain adequate nutritional status. Herein, we report a successful intestinal adaptation of a patient with SBS through 13 times intensive nutritional support team (NST) managements. A thirty-five-year-old woman who could not eat due to intestinal discontinuity visited Seoul National University Hospital for reconstruction of the bowel. She received laparoscopic Roux-en-Y gastric bypass (RYGB) due to morbid obesity in Jan 2013 at a certain hospital and successfully reduced her weight from 110 kg to 68 kg. However, after a delivery of the second baby by cesarean section in Jul 2016, most of small bowel was herniated through Peterson's defect, and emergent massive small bowel resection was performed. Thereafter, she visited our hospital for the purpose of intestinal reconstruction. In Sep 2016, she received side-to-side gastrogastrostomy and revision of double barrel enterostomy. The remaining small bowel included whole duodenum, 30 cm of proximal jejunum, and 10 cm of terminal ileum. Pylorus and ileocecal valves were intact. The patient given only PN after surgery was provided rice-based soft fluid diet after 10 day of operation. Through intensive nutritional management care, she could start solid meals, and finally stop the PN and eat only orally at 45 days postoperatively. Three nutritional interventions were conducted over 2 months after the patient was discharged. She did not require PN during this period, and maintained her weight within the normal weight range. Similar interventions could be used for other patients with malabsorption problems similar to SBS.

KEYWORDS:

Intensive nutritional management; Oral intake; Short bowel syndrome

Conflict of interest statement

Conflict of Interest: The authors declare that they have no competing interest.

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