Nutrition Interventions for children with Special Health Care Needs was first published in 1989 and has been updated twice since then. Lori has been involved in every edition on the advisory board and/or as a contributor. The last edition was published in 2010. Stay tuned for a new edition coming out in the next 2 years.
This is a chapter written by Lori (she contributed to other chapters as well):
Nutrition Interventions for Short Bowel Syndrome
Chapter 20, pages 227-246
Lori Brizee, MS, RD, CSP, LD
Definition of Short Bowel Syndrome:
Short Bowel Syndrome (SBS) is defined as malabsorption resulting from anatomical or functional loss of a significant length of the small intestine. This occurs most commonly after bowel resection in the newborn period (e.g., secondary to necrotizing enterocolitis, mid-gut volvulus, gastroschisis, or intussusception). SBS can also result from trauma to the bowel (e.g., with an auto accident or fall, or with severe nonaccidental trauma). The amount of bowel that must be lost to produce malabsorption is variable and depends on which sections are lost and whether or not the ileocecal valve is preserved. The normal length of small intestine is approximately 300-850 cm for an adult, 200-250 cm for an infant over 35 weeks gestation, and approximately 100-120 cm for a premature infant less than 30 weeks gestation. Loss of greater than 80% of the small bowel is associated with increased requirement for parenteral nutrition support and decreased overall survival. When the ileocecal valve is lost, the resulting risk for bacterial contamination of the small intestine from the colon mandates more small intestine for tolerance of oral/enteral feeding (1,2,3).
