Wenjing Zong1, Renee Troutt2, Jamie Merves1. 1. Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA. 2. Division of Clinical Nutrition, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Abstract
BACKGROUND: Blenderized feeds consisting of whole food components are emerging as a preferred approach to enteral nutrition. However, there is limited evidence-based guidance for this strategy in short bowel syndrome (SBS). We aimed to explore the tolerance and clinical outcome of blenderized feeds in patients with SBS. METHOD: We conducted a single-center, retrospective study of blenderized feeds in pediatric SBS. Of the 376 patients screened, 58 met inclusion criteria. Three patients were excluded because of a history of bowel transplant. Demographics, clinical history, and nutrition history were collected and analyzed. RESULT: Patients had improved diarrhea though worsening gas while receiving blenderized feeds. There was no significant difference in small bowel length in patients who discontinued blends compared with those who continued. However, patients with colonic resection were more likely to discontinue the blends. In a subgroup of patients who lost weight despite improved diarrhea (n = 19), most had a history of ileocecal valve (ICV) and colonic resection, but no difference in small bowel length compared with those who did not lose weight. CONCLUSION: Our cohort of patients with SBS experienced improved gastrointestinal symptoms and stool quality on blenderized feeds. Patients without an ICV and with colonic resection were more prone to weight loss. Stepwise titration of blenderized formula with previous formula regimen may be needed in a subset of patients to optimize tolerance and weight gain. Further study is warranted to understand factors contributing to variable tolerance and weight gain on blenderized formulas to guide their use in patients with SBS.
BACKGROUND: Blenderized feeds consisting of whole food components are emerging as a preferred approach to enteral nutrition. However, there is limited evidence-based guidance for this strategy in short bowel syndrome (SBS). We aimed to explore the tolerance and clinical outcome of blenderized feeds in patients with SBS. METHOD: We conducted a single-center, retrospective study of blenderized feeds in pediatric SBS. Of the 376 patients screened, 58 met inclusion criteria. Three patients were excluded because of a history of bowel transplant. Demographics, clinical history, and nutrition history were collected and analyzed. RESULT: Patients had improved diarrhea though worsening gas while receiving blenderized feeds. There was no significant difference in small bowel length in patients who discontinued blends compared with those who continued. However, patients with colonic resection were more likely to discontinue the blends. In a subgroup of patients who lost weight despite improved diarrhea (n = 19), most had a history of ileocecal valve (ICV) and colonic resection, but no difference in small bowel length compared with those who did not lose weight. CONCLUSION: Our cohort of patients with SBS experienced improved gastrointestinal symptoms and stool quality on blenderized feeds. Patients without an ICV and with colonic resection were more prone to weight loss. Stepwise titration of blenderized formula with previous formula regimen may be needed in a subset of patients to optimize tolerance and weight gain. Further study is warranted to understand factors contributing to variable tolerance and weight gain on blenderized formulas to guide their use in patients with SBS.
Authors: Mahesh S Desai; Anna M Seekatz; Nicole M Koropatkin; Nobuhiko Kamada; Christina A Hickey; Mathis Wolter; Nicholas A Pudlo; Sho Kitamoto; Nicolas Terrapon; Arnaud Muller; Vincent B Young; Bernard Henrissat; Paul Wilmes; Thaddeus S Stappenbeck; Gabriel Núñez; Eric C Martens Journal: Cell Date: 2016-11-17 Impact factor: 41.582