Nutritional interventions and outcomes of children with short bowel syndrome in a tertiary hospital setting in South Africa

Abstract

Objectives: To describe the impact of nutritional interventions on the outcomes of children with short bowel syndrome (SBS). Design: This was a retrospective descriptive observational review where data were obtained from the patient’s medical records. Subjects and setting: Children with SBS between the ages of 0 and 24 months who obtained this diagnosis between January 2005 and December 2015 at a tertiary paediatric hospital in Cape Town were investigated. Results: There were 46 patients (62% male, 38% female) included in the study. The median duration of parenteral nutrition (PN) support was one month (0.6, 2.2 months), after which 83% of patients were weaned from PN. Enteral nutrition was commenced in 96% of patients, with the majority (n = 36; 82%) starting on day six (±6; range 1–29 days) postoperatively and 80% of patients attaining full feeds at median 1.2 months (0.2, 36 months). Patients displayed a mean weight and length gain of 15 g/day (±4; range 19–92 g) and 2 cm/month (±1.4; range 0.25–4 cm) respectively. The main complications were PN-associated cholestasis (n = 17), fat malabsorption (n = 13) and vitamin D deficiency/insufficiency (n = 5). Conclusion: This study showed that early initiation of PN support was attained, and that most patients were able to achieve enteral autonomy.