some potentially interesting tidbits re past present and future
Nutritional Interventions during Pregnancy for the Prevention or Treatment of Maternal Morbidity and Preterm Delivery: An Overview of Randomized Controlled Trials
http://jn.nutrition.org/content/133/5/1606S.short
This overview assesses the effectiveness of nutritional interventions to prevent or treat maternal morbidity, mortality and preterm delivery. Cochrane systematic reviews and other up-to-date systematic reviews and individual randomized controlled trials were sought. Searches were carried out up to July 2002. Iron and folate supplements reduce anemia and should be included in antenatal care programs. Calcium supplementation to women at high risk of hypertension during pregnancy or low calcium intake reduced the incidence of both preeclampsia and hypertension. Fish oil and vitamins E and C are promising for preventing preeclampsia and preterm delivery and need further testing. Vitamin A and β-carotene reduced maternal mortality in a large trial; ongoing trials should provide further evaluation. No specific nutrient supplementation was identified for reducing preterm delivery. Nutritional advice, magnesium, fish oil and zinc supplementation appear promising and should be tested alone or together in methodologically sound randomized controlled trials. Anema in pregnancy can be prevented and treated effectively. Considering the multifactorial etiology of the other conditions evaluated, it is unlikely that any specific nutrient on its own, blanket interventions or magic bullets will prevent or treat preeclampsia, hemorrhage, obstructed labor, infections, preterm delivery or death during pregnancy. The few promising interventions for specific outcomes should be tested or reconsidered when results of ongoing trials become available. Until then, women and their families should receive support to improve their diets as a general health rule, which is a basic human right.
The Eccentricities of Nourishing the Infant With Abdominal Anomalies
http://journals.lww.com/topicsinclinica ... ith.6.aspx
Recommendations for overcoming anatomical challenges
Any loss of the small bowel necessitates consideration of macro- and micronutrient absorption. All feedings, whether oral or via tube, promote physiologic responses that may enhance intestinal adaption.37 Controversy surrounds the choice of formulas for those with shortened bowel lengths such as SBS and ostomies. Some studies report the benefits of standard formula38 while others tout the benefits of hydrolyzed or elemental formulas.32,39 There are pros and cons to any formula choice, and all recommendations must be considered on an individual basis within the surgical context of the patient.
Short-bowel syndrome in children and adults
http://www.sciencedirect.com/science/ar ... 8597005477
Short-bowel syndrome is the malabsorptive state that follows extensive resection of the small intestine. Potential long-term survival without parenteral nutrition heavily depends on stimulation of the process of intestinal adaptation, through which the remaining small intestine gradually increases its absorptive capacity. This process is heavily nutrient dependent, and aggressive use of enteral nutrition is required to stimulate its completion. A combination of osmotic sensitivities, nutrient malabsorption, bowel dilatation and dysmotility, and changes in bacterial flora influence the symptoms and the management of this disorder. Chronic complications include parenteral nutrition-induced liver disease, nutrient deficiency states, and, frequently, small bowel bacterial overgrowth. Intestinal transplantation has been successfully developed in some centers in the United States, and preliminary experience suggest a long-term survival of 50%-75%, better in patients receiving an isolated intestinal transplant than a combined liver/bowel transplant. The ultimate role of intestinal transplantation is still undergoing evaluation.
Multiple Micronutrient Deficiencies in a Child With Short Bowel Syndrome and Normal Somatic Growth
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3253358/
Children with short bowel syndrome (SBS) are at risk for a variety of macro- and micronutrient deficiencies and other complications as a result of loss of small bowel surface area (1). The amount and location of small intestine loss in SBS will generally define the degree of nutrient malabsorption and the likelihood of micro-nutrient deficiencies. Duodenal resection, for example, can result in iron and folate deficiencies. Extensive jejunal resection can lead to malabsorption of carbohydrates, proteins, and calcium. The terminal ileum is the primary site of absorption of vitamin B12 and bile salts. Bile salt malabsorption can in turn present with steatorrhea and deficiencies of vitamins A, D, E, and K. Ileocolonic resection can predispose to several problems as a result of the loss of the ileocecal valve, resulting in loss of the ileal break, increased risk of anastomotic ulcers, and bacterial overgrowth.
The extent of nutrient malabsorption in SBS is generally assessed by history and physical examination, including assessment of growth parameters. Normal somatic growth generally implies adequate energy and macronutrient absorption. We describe a patient with SBS who developed severe iron-deficiency anemia and multiple micronutrient deficiencies despite normal growth, full oral intake, and limited ileal resection.
active members shape site content. if there is a problem, speak up!
use the report button to flag problematic post content to volunteer moderators' attention.
BOOOOOOOOOO