Impact of Care in a Multidisciplinary Clinic on a Child With Ultrashort Gut

Abstract

Short bowel syndrome (SBS) is a condition characterized by dependence on total parenteral nutrition due to the inability of the intestines to absorb adequate nutrients, electrolytes, and water. SBS is most commonly seen in pediatric patients after extensive small bowel resection due to necrotizing enteroclolitis, intestinal atresias, gastroschisis, or volvulus (Cummings & Mercurio, 2012). The management of children with SBS focuses on maximizing enteral nutrition while mitigating the potential life-threatening complications of central venous line infections and liver failure. The process of slowly advancing enteral feedings and promoting enterocyte proliferation and villus height is termed adaptation (Warner, 2013). These changes provide an increased surface area for nutrient absorption. The promotion of adaptation is the cornerstone of pediatric intestinal rehabilitation. In the following paragraphs, a case study is presented describing the experiences of a child with ultrashort gut and her journey to independence from total parenteral nutrition at 3 years old. Key interventions that may have played a role in this child's success will be discussed.