Short Bowel Syndrome in Children

Short bowel syndrome (SBS) is defined as intestinal failure following a loss of intestinal length which causes marked maldigestion and malabsorption of dietary nutrients and induces major faecal issues, loss of energy, nitrogen, and fat. Intestinal failure and SBS continue to be important clinical problems due to their high mortality and morbidity rates, as well as their devastating socio-economic effects. Although intestinal transplantation has emerged as a feasible alternative in the treatment of children with SBS in the last two decades, intestinal adaptation remains the only chance for survival in a subset of these patients. Intestinal adaptation is defined as a process of progressive recovery from intestinal failure following bowel resection. In this book, the aetiology of SBS, its pathophysiology, and the cellular and molecular mechanisms of intestinal adaptation are reviewed. The most common complications of SBS, including intestinal failure associated liver disease and sepsis, are outlined with strategies to reduce them. The potential role of tissue engineering for SBS that go beyond the "simple" generation of the tubular small intestine is discussed. Such knowledge will likely provide the basis for further advances in the treatment of patients with short bowel syndrome and suggest new therapeutic strategies to maintain gut integrity, eliminate the dependence on total parenteral nutrition, and avoid the need for intestinal transplantation.