Intestinal adaptation in short bowel syndrome. What is new?

Short bowel syndrome (SBS) is a well-known cause of intestinal failure (IF) (1). SBS occurs after extensive resection of the small bowel (RSB) resulting in a bowel length of less than 150/200 cm. The colon may have been partially or completely removed. SBS patients experience severe water and nutrient malabsorption, so that they are often managed with parenteral nutrition (PN) to supplement their oral intake (2-4). A complete understanding of the pathophysiology of SBS and postoperative adaptations may allow identifying the spontaneous processes that compensate for the reduction in absorptive surface. A better knowledge of these adaptive mechanisms may help to improve the management of patient nutrition, to reduce the need for PN and to prevent D-encephalopathy episodes. This review focuses on the overall adaptations described in adult SBS patients but does not review pediatric cases. PMID:El síndrome del intestino corto es la primera causa de fallo intestinal (que requiere suplementación intravenosa de fluidos, electrolitos y/o calorías). La adaptación fisiológica intestinal ocurre uno a dos años después de la resección quirúrgica. Esta adaptación incluye hiperfagia, cambios en la microbiota, cambios morfológicos intestinales (incluida la hiperplasia), adaptaciones hormonales y otros… El colon desempeña un papel importante y permite la recuperación hidroelectrolítica y energética. Es posible mejorar la adaptación fisiológica mediante la optimización de la intervención dietética, restaurando la continuidad y tratando con factores de crecimiento, como el análogo del GLP-2 (glucagon-like peptide-2)