Enteral nutrition in pediatric intestinal failure: does initial feeding impact on intestinal adaptation?

Teresa Capriati, Valerio Nobili, Laura Stronati, Salvatore Cucchiara, Francesca Laureti, Alessandra Liguori, Elaine Tyndall, Antonella Diamanti

Research output: Contribution to journalReview article

Abstract

Introduction: Primary IF can be due to impaired gut length or impaired gut function; short bowel syndrome (SBS) is the leading cause of IF. In IF patients complete enteral starvation should be avoided whenever possible and enteral/oral nutrition (EN/ON) should be employed at the maximum tolerated amount in each phase of the clinical evolution of IF. Intraluminal nutrients have stimulatory effects on epithelial cells and on trophism that enhance intestinal adaptation. Areas covered: Evidence for nutritional interventions in pediatric IF is limited and of poor quality. Clinical practice in SBS feeding are more ‘experience-based’ rather than ‘evidence-based’ and this dearth of clinical evidence is partly due to the rarity of this condition. This review updates knowledge concerning the impact of the initial diet with EN/ON in neonatal onset SBS in the process of bowel adaption. Expert commentary: Human milk resulted the preferred starting diet and it is generally combined with amino-acids (AAs) in Northern America and with hydrolyzed proteins (HFs) in Europe; polymeric diet is rarely employed. HFs were not more effective than AAs in promoting intestinal adaptation.

Original languageEnglish
Pages (from-to)741-748
Number of pages8
JournalExpert Review of Gastroenterology and Hepatology
Volume11
Issue number8
DOIs
Publication statusPublished - Aug 3 2017

Keywords

  • Children
  • enteral nutrition
  • intestinal adaptation
  • intestinal failure
  • short bowel syndrome

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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