A multidisciplinary team evaluation of management guidelines for adult short bowel syndrome.

Elizabeth Wall, Hilary Catron, Adela Delgado, Sophie Greif, Jean Herlitz, Lisa Moccia, Edward Lozano, David Mercer, Tim Vanuytsel, Mark Berner-Hansen, Narisorn Lakananurak, Leah Gramlich

Journal: Clinical nutrition ESPEN 2023;54():41-44

PMID: 36963887

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Abstract

BACKGROUND & AIMS

An international, multidisciplinary management working group (MWG) convened to review clinically useful short bowel syndrome (SBS) literature and identify gaps and inconsistencies in the management of adults with SBS.

METHODS

Using nominal group technique for literature review, key publications were identified, discussed, and ranked by importance related to management of SBS. Gaps in management recommendations for SBS were identified upon critical review of the selected publications.

RESULTS

Five guidelines, seven review articles, one series of six articles, and one single center series were selected and prioritized for their importance to SBS management. Evaluation of the articles by the MWG identified ten gaps and opportunities to standardize and improve SBS management.

CONCLUSION

The main practice areas in need of more definitive guidelines are the management of high stool output and strategies to improve absorption of medications, nutrients, and fluids. An understanding of current real-world clinical practices related to these gaps could allow for development of best practice standards and improve patient-focused care.

Address: Clinical Nutrition, University of Chicago Medicine, Chicago, IL, USA. Electronic address: [email protected].; Adult Intestinal Rehabilitation, University of Nebraska Medical Center, Omaha, NE, USA.; Department of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; Alberta Health Services, Royal Alexandra Hospital, Edmonton, AB, Canada.; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and HumboldtUniversität zu Berlin Department of Hepatology and Gastroenterology, Berlin, Germany.; Clinical Nutrition, University of Chicago Medicine, Chicago, IL, USA.; Center for Human Nutrition, Cleveland Clinic, Cleveland, OH, USA.; Clinical Pharmacy, University of Chicago Medicine, Chicago, IL, USA.; Surgery, University of Nebraska Medical Center, Omaha, NE, USA.; Gastroenterology and Hepatology, Katholieke Universiteit Leuven, Leuven, Belgium.; Digestive Disease Center K, Bispebjerg University Hospital of Copenhagen, Denmark; Zealand Pharma, Denmark.; Department of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; Division of Clinical Nutrition, Department of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.; Department of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.

DOI: 10.1016/j.clnesp.2022.12.029

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MeSH Terms: Humans, Adult, Short Bowel Syndrome, Nutrients, Patient Care Team