Clinical Observations: Beyond the Prescription: Optimizing the Diet of Patients with Short Bowel Syndrome

The nutrition and metabolic problems of patients with short bowel syndrome (SBS) are complex. Although much effort has been devoted to optimizing the provision of parenteral nutrition to these patients, much less attention has been devoted to the role that an optimal enteral or oral diet might play in the management of these individuals. In addition to the role that luminal nutrition plays in bowel adaptation following resection, the provision of an appropriate diet prescription can influence absorption or stool or ostomy output. To optimize the effect of diet manipulation, the diet prescription must be translated into foods, and the foods into appropriate meals that recognize the variability that exists in this patient population. In addition to reviewing available literature, observations based upon our clinical experience caring for nearly 400 patients with SBS are presented.