Short bowel syndrome (SBS) results from extensive resection of the small intestine +/- the colon, due to disease. Malnutrition ensues as a result of malabsorption and is treated with total parenteral nutrition (TPN). Patients with severe SBS remain chronically dependent on TPN with its attendant risks, yet must cope with debilitating diarrhea. Long-chain fatty acids (such as oleic acid) in the intestinal lumen slow transit in more proximal bowel in normal subjects and patients with chronic diarrhea. This delay in transit, if it occurs in SBS and is sustained, could enhance digestion and absorption of nutrients and defray the need for TPN. The primary aims of the proposed investigation are: 1. To determine in a dose-response trial the dose of preprandial oleic acid that will be acceptable to patients with SBS, and that will result in slowing of intestinal transit time. 2. To determine by a randomized double-blind placebo-controlled crossover pilot trial the patient burden, and the effect size of oleic acid treatment on transit time, nutrient absorption and quality of life. The long-term objectives of the proposed line of investigation are to improve the nutritional care and quality of life of patients with SBS. If the oleic acid treatment proves promising in the current pilot study, a larger multi-center trial (to include pediatric patients) will be designed to evaluate transit, micro- and macro-nutrient absorption, nutritional status, quality of life, and growth (children).
| Compher, Charlene W; Kinosian, Bruce P; Metz, David C (2009) Ghrelin does not predict adaptive hyperphagia in patients with short bowel syndrome. JPEN J Parenter Enteral Nutr 33:428-32 |
| Compher, Charlene W; Kinosian, Bruce P; Rubesin, Stephen E et al. (2009) Energy absorption is reduced with oleic acid supplements in human short bowel syndrome. JPEN J Parenter Enteral Nutr 33:102-8 |
| Compher, Charlene; Rubesin, Stephen; Kinosian, Bruce et al. (2007) Noninvasive measurement of transit time in short bowel syndrome. JPEN J Parenter Enteral Nutr 31:240-5 |
