P1.23: Use of Pureed Green Beans Through a G-tube in Pediatric Patients with Short Bowel Syndrome – A Single Center Experience

Abstract

Background: Pectin and other water-soluble fibers have been used in certain patients with short bowel syndrome. Fermented fibers may provide energy contribution via short chain fatty acids produced by colonic bacteria, while soluble fibers that retain a gel may improve the consistency of watery or loose stools and thus decrease stool output. At our institution, we aimed to study the effects of pureed green beans, a good source of pectin, given in a reliable and easy manner, through a G-tube. Methods: Pureed green beans administered via syringe directly into the G-tube was prescribed in a handful of patients with short bowel syndrome. Dose of green beans was adjusted at regularly scheduled clinical visits. Patients and their stools were closely monitored. Results: Of the 71 intestinal rehabilitation patients at our center, 7 are currently receiving pureed green beans through G-tube. All patients experienced a decrease in stool frequency and 6 of them experienced improvement in stool consistency. Over half of the patients also tolerated a decrease in loperamide. Of the 6 patients receiving either TPN or IV hydration, 5 tolerated a decrease in the overall volume. One patient was weaned off of IV hydration fluids entirely. Please refer to Table 1. Conclusion: Overall, our cases highlight the improvement in stool frequency and consistency, TPN volume requirements, and loperamide administration following the administration of pureed green beans into a G-tube. For our patients with G-tubes and difficult to manage loose stools, the introduction of pureed green beans is now being considered more frequently. Potential future research may include: examining if higher doses of green beans increase the risk of malabsorption of certain nutrients (such as magnesium, zinc, and iron), monitoring the incidence of central line infections following stool normalization, and studying the effects of specific fibers or foods on the microbiome in patients with short bowel syndrome.