Short bowel syndrome: Epidemiology, pathophysiology, and adaptation

Fernando Navarro, Wallace A. Gleason, J. Marc Rhoads, Ruben E. Quiros-Tejeira

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Short bowel syndrome (SBS) is a relatively common, often lethal, and highly costly medical problem in North America. Necrotizing enterocolitis (NEC) is the leading cause of SBS in the United States. An important fact to remember is that the length of the small bowel in a 28-week preterm infant is about 150 cm and in a term infant is about 250 cm. Twenty percent of this length is generally sufficient to allow dependence on parenteral nutrition (PN) via intestinal adaptation. This process is driven by significant increases in circulating trophic hormones, such as cholecystokinin, epidermal and keratinocyte growth factors, growth hormone, insulin-like growth factor-1, and glucagon-like peptide-2. These hormones produce hypertrophy and hyperplasia of the villi, along with increases in specific brush border membrane absorption mechanisms, such as glucose-sodium cotransport (via SGLT-1) and peptide transport (via Pep-T1). Currently, the best clinical markers of intestinal adaptation are the calculated percentage of enteral versus parenteral calories in a growing infant who has SBS and the serum concentrations of citrulline, an amino acid synthesized by mature enterocytes that has been used as a measure of functional intestinal mass.

Original languageEnglish (US)
Pages (from-to)e330-e338
JournalNeoReviews
Volume10
Issue number7
DOIs
StatePublished - Dec 1 2009

Fingerprint

Short Bowel Syndrome
Epidemiology
Glucagon-Like Peptide 2
Hormones
Citrulline
Necrotizing Enterocolitis
Enterocytes
Cholecystokinin
Parenteral Nutrition
Somatomedins
Microvilli
North America
Keratinocytes
Premature Infants
Hypertrophy
Growth Hormone
Small Intestine
Hyperplasia
Biomarkers
Sodium

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Short bowel syndrome : Epidemiology, pathophysiology, and adaptation. / Navarro, Fernando; Gleason, Wallace A.; Rhoads, J. Marc; Quiros-Tejeira, Ruben E.

In: NeoReviews, Vol. 10, No. 7, 01.12.2009, p. e330-e338.

Research output: Contribution to journalArticle

Navarro, Fernando ; Gleason, Wallace A. ; Rhoads, J. Marc ; Quiros-Tejeira, Ruben E. / Short bowel syndrome : Epidemiology, pathophysiology, and adaptation. In: NeoReviews. 2009 ; Vol. 10, No. 7. pp. e330-e338.
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