Chapter 7 - Enteral Access and Enteral Nutrition in Patients With Short Bowel Syndrome

Abstract

Short bowel syndrome (SBS) is a complex disease that often requires complex solutions for providing nutritional support. Although parenteral nutrition (PN) is the most common form of nutritional support for patients with SBS, oral nutrition or enteral nutrition (EN) may be used alone or in combination with PN. In order to provide EN a patient may first receive enteral access. Temporary feeding tubes, such as nasogastric and nasojejunal tubes, are uncommon for use in this population other than on a temporary basis. Percutaneous enteral access can be placed by the radiologist, endoscopist, or surgeon and is often dependent on a healthcare center’s available expertise. Both gastric and jejunal enteral access options are commercially available. A decision on what enteral access tube to use is driven by the patients gut anatomy, tolerance to enteral feeding, and comorbid disease states. Research on the use of enteral feeding in the patient with SBS is limited; the use of continuous enteral feeding has been shown to be associated with increased absorption of macronutrients. Data evaluating biomarkers for determination of which patient with SBS can be successfully fed with EN are inconsistent in their findings.