The Short Gut

Terapia nutricional oral em pacientes com Síndrome do Intestino Curto

“…A retirada de uma ou mais porções do intestino delgado resulta em processos carenciais de maior ou menor gravidade, dependendo da extensão e do tempo de duração da doença, sendo a Síndrome do Intestino Curto (SIC) responsável pelos quadros mais sérios e graves (Klish & Putnam, 1981;Thompson et al, 1986).…”

“…Quanto mais grave for a síndrome de má absorção e quanto menor o segmento do intestino delgado remanescente, mais freqüentes serão as internações (Klish & Putnam, 1981). Não existe consenso quanto a forma e composição da terapêutica nutricional a ser adotada com estes pacientes (Messing et al, 1991;Marchini et al, 1994 A dieta via oral prescrita para a manutenção do estado nutricional destes pacientes, concomitante ou não a nutrição parenteral, tinha por objetivo fornecer 35 kcal/kg/dia, 1,5 g proteína/kg/dia e ser adequada em relação as recomendações diárias de vitaminas e minerais, segundo o Recommended Dietary Allowances (RDA) (National Research...,1989).…”

Absorption of valproic acid from the gastrointestinal tract of the piglet

“…Loss of a significant portion of the small intestine and/or colon and an inability to maintain enteral nutrition with the remaining bowel are typical. Factors that influence the extent of nutrient absorption include: (a) the extent and site of intestine loss; (b) the presence or absence of the ileocecal valve; (c) the health of the remaining intestine and other organs of digestion; and (d) the adaptation of the remaining small bowel and stomach (6). Compensatory growth of the bowel wall occurs with an increase in length and diameter of the remaining gut In cases where the SBS patients also suffer from epilepsy, their nutritional state and the absorptive surface available may be crucial to successful oral antiepileptic therapy.…”

“…Immediate treatment involves identifying and eliminating the underlying cause of the seizure if possible, and administration of an antiepileptic drug, such as valproic acid. Oral administration may be' necessary because of irregular absorption after intramuscular or subcutaneous injection due to the limited muscle mass and diminished peripheral blood perfusion of neonates and infants (6). In addition, limited access sites may be available for intravenous administration in these patients.…”

Zur Bedeutung niederosmolarer Diäten für den oralen Nahrungsaufbau bei schwerster Malabsorption - Klinische Beobachtungen am Beispiel subtotal dünndarmresezierter Säuglinge

“…196 (1984) schleimhaut ohne direkten Kontakt mit oral aufgenommener Nahrung rasch atrophiert (8,20). Da nicht-nutritive Substanzen oder Ballaststoffe diesen Prozeß nicht verhindern, muß man annehmen, daß der Resorption von Nährstoffen als solcher sowie dem Stoffwechsel der Schleimhau t eine Schlüsselstellung rur diejenigen Mechanismen zukommt, welche zur Regeneration und Adaptation des Darmes ftihren (7,11,13,29,31). Daraus eptsteht die therapeutische Aufgabe, die Resorptionsfahigkeit der Nahrungen für diese Kinder zu optimieren.…”