Background and aim: Short bowel syndrome (SBS) is a rare malabsorptive condition and represents the most common mechanism of intestinal failure. The aim of our study is to comprehensively evaluate the nutritional status (NS) of SBS patients by analyzing a consecutive cohort of seven patients at the Gastroenterology Department, University of Palermo.
Methods: NS was assessed using anthropometric measurements, the handgrip test (HT), and bioimpedance analysis from March 2023 to October 2023.
Results: A total of 43% of the patients were underweight. Based on the modified EWGSOP 2010 criteria, 42% had a phase angle (PA) <4.45, indicating non-severe sarcopenia. According to the HT and the skeletal muscle index (SMI), 71% were sarcopenic. A total of 72% of the patients received enteral nutrition (EN) and/or parenteral nutrition (PN), while 14% had never undergone nutritional therapy (NT) and another 14% had previously received PN.
All patients needed essential vitamin support; some required additional electrolytes, magnesium, or a glutamine and essential amino acid mixture to support muscle and plasma protein synthesis in protein malnutrition. Immunonutrition was adopted in in 57.1% of cases.
Follow-Up: After six months, 60% of patients showed improvement in PA and SMI values, as well as in muscle strength. A total of 40% experienced slight weight loss; among these, 50% had worsened PA despite maintaining or increasing SMI and HT values. Weight loss was attributed to non-adherence to nutritional guidelines. Changes in nutritional assessment over time led to adjustments in the dosage and frequency of nutritional bag administration, with many patients reducing infusion volumes due to improved intestinal absorptive capacity.
Discussion and Conclusions: An adequate macro- and micronutrient intake is crucial for SBS patients. Inadequate NT can contribute to sarcopenia, with malabsorption episodes exacerbating muscle catabolism. Frequent monitoring of electrolytes, use of PN and EN, and fluid balance is essential. Most SBS patients are malnourished and sarcopenic; timely NT and medication can lead to clinical improvement and enhanced intestinal absorption, reducing infusion volume needs.
