Infantile Short Bowel Syndrome: short and long term evaluation

Infantile short bowel syndrome is a condition which is characterized by malabsorption of nutrients, as a result of congenital intestinal shortening or massive small bowel resection. Survival rates have improved over the years, but morbidity remains high and clinical management of these patients is complex. The overall aim of this thesis is to describe the acute and long term consequences of infantile short bowel syndrome. The main conclusions obtained from the studies described in this thesis are the following: - Improvement in the care of children with SBS, notably with regard to nutritional status and to stimulating early nutritional intake is necessary. - Adequate monitoring of nutritional status in critically ill children calls for weekly assessment. An adequate infrastructure which guarantees structural availability of trained personnel is the cornerstone is this setting. - At the moment, it is not possible to solely base the nutritional regimen of children with SBS on evidence obtained from previous scientific studies. - Subjects with a history of infantile short bowel syndrome had shorter stature and lower bone mineral content (BMC) than healthy controls, but strikingly, had normal weight for height and percentages of body fat. - Subjects with a history of infantile short bowel syndrome had impaired health related quality of life.- Treatment of short bowel syndrome requires considerable resource consumption, especially when patients depend on parenteral nutrition. Interdisciplinary teams have the potential to facilitate home parenteral nutrition and thus reduce health care costs, while at the same time benefiting patients's health.

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