What is the prognosis (outlook) for children who have short bowel syndrome?
The prognosis for infants and children who have short bowel syndrome can be good, depending on the residual length of the intestine. However, they will need lifelong follow-up care. Children need to be closely monitored for any nutritional deficiencies or other conditions that may result from continued use of enteral or parenteral nutrition. Overall, quality of life and chance of coming off TPN have improved with a better understanding of the problem and preventing complications.
The main causes of death among infants and children who receive parenteral nutrition are infections and disorders of the liver and biliary tract (the pathway by which bile flows from the liver to the small intestine). Infectious complications may become less frequent with recent advances in protocols for the care of central lines in children. Cholestasis (a condition where bile cannot flow from the liver to the duodenum) is a common complication following long-term use of total parenteral nutrition. Newer approaches to managing TPN have helped to decrease the chance of cholestasis and associated liver disease.
A team approach involving pediatric gastroenterologists, pediatric dietitians, pharmacists, pediatric surgeons and transplant surgeons, and social workers is vital in managing and improving outcomes in patients with short bowel syndrome.