Nutritional Management in the Compromised Gut: Short Bowel Syndrome, Enterocutaneous Fistula, and Stoma

Nutrition in patients with a compromised gut is a challenge requiring a multidisciplinary management and necessitates individualized nutritional planning. Intestinal failure is defined as significant deficit in gut absorption of micro and macronutrients such that intravenous supplementation is necessary to sustain life. If absorption is inadequate, however intravenous supplementation is not required, it is called intestinal insufficiency. Short bowel syndrome and entero cutaneous fistula are the most common conditions leading to intestinal insufficiency and failure. These conditions in the initial phase may lead to significant loss of fluids and electrolytes and require multidisciplinary team management. Definite plan for restoration of adequately functioning bowel after stabilization of patient is important. Based on evidences, recommendations for nutritional management in such patients were thoroughly discussed and approved by the Gastrointestinal nutrition core committee of the Indian Association of Parenteral and enteral nutrition (IAPEN). Keywords: Short bowel syndrome, Enterocutaneous fistula, Nutrition