Q. Dietary Management for short bowel syndrome?

It must be evident from the symptoms listed above that the disease results in reduced food intake, impaired absorption and hence weight loss. The patient generally has depleted reserves for several nutrients. The Nutritional management goals should therefore include the following objectives:

• Relieve the symptoms

• Correct nutritional deficiencies,

• Control inflammation and relieve pain.

The dietary considerations should be aimed to give sufficient calories. Special feeding methods such as enteral and parenteral feeding may have to be incorporated. The following points should be kept in mind:

• A high calorie and low residue diet that also supplies the vitamins, minerals and other nutrients is necessary. The food should be bland.

• The food should be divided into several small meals of protein and complex carbohydrates. A minimum of concentrated sweets, fruit juices should be included.

• Nutritional supplements and dietary restrictions are used in treating SBS. The vitamin and mineral supplements may have to be several times greater than the standard recommended daily allowances in order to maintain adequate tissue functioning.

• Special feeding to b,e given when essential (enteral and parenteral feeding). Oral feedings are started using a basic soft diet, which can be digested without much work required in the bowel. The complexity of the diet is gradually increased over time, allowing the remaining digestive system to adapt. Finally, patients are weaned entirely off the enteral feeding and receive nutrition completely from oral intake of regular foods. If parenteral feeding is must, it could be given but enteral feeding should be preferred.

Dietary management is supported with drug therapy. Frequently used medications include anti-inflammatories, immune suppressants, antibiotics, corticosteroids and antidiarrhoeals.