Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Division of Clinical Nutrition, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Nutr Clin Pract. 2022 Aug;37(4):913-920. doi: 10.1002/ncp.10866. Epub 2022 May 31.
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.
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.
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.
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.
由全食物成分组成的匀浆饮食正成为肠内营养的首选方法。然而，在短肠综合征（SBS）中，这种策略的循证指导有限。我们旨在探讨 SBS 患者使用匀浆饮食的耐受性和临床结局。
我们对儿科 SBS 患者的匀浆饮食进行了单中心回顾性研究。在筛选的 376 名患者中，有 58 名符合纳入标准。由于有肠移植史，3 名患者被排除在外。收集并分析了患者的人口统计学、临床病史和营养史。
患者在接受匀浆饮食后腹泻有所改善，但气体增多。与继续使用匀浆饮食的患者相比，停止使用匀浆饮食的患者小肠长度没有显著差异。然而，有结肠切除术的患者更有可能停止使用匀浆饮食。在尽管腹泻改善但体重减轻的患者亚组（n=19）中，大多数患者有回盲瓣（ICV）和结肠切除术病史，但与未减轻体重的患者相比，小肠长度无差异。
我们的 SBS 患者队列在接受匀浆饮食后胃肠道症状和粪便质量得到改善。没有 ICV 且有结肠切除术的患者更容易出现体重减轻。在一部分患者中，可能需要逐步调整匀浆配方与之前的配方方案，以优化耐受性和体重增加。需要进一步研究以了解导致匀浆配方耐受性和体重增加差异的因素，从而指导 SBS 患者使用。
