Clinical Tolerance and Microbiome Changes Following Fiber Food Introduction in Short Bowel Syndrome
Children's Hospital of Philadelphia
Summary
Short bowel syndrome (SBS) is a rare but challenging condition in which patients have insufficient bowel length to meet fluid, electrolyte, and nutrient requirements without parenteral support. The purpose of this study is to determine how well dietary fiber is tolerated in patients with short bowel syndrome compared to patients without short bowel syndrome based on assessment of gastrointestinal symptoms, and corresponding changes in microbiome composition and metabolomics.
Description
Short bowel syndrome (SBS) is a rare but challenging condition in which patients have insufficient bowel length to meet fluid, electrolyte, and nutrient requirements without parenteral support. The goal of SBS treatment is to achieve enteral autonomy using strategies that optimize intestinal absorption while minimizing unpleasant gastrointestinal (GI) side effects. One strategy that has emerged is the addition of soluble fiber to enteral formula, and this strategy has gained popularity in clinical practice as fiber-rich formulas comprised of blenderized whole foods have become commercially ava…
Eligibility
- Age range
- 0–18 years
- Sex
- All
- Healthy volunteers
- Yes
Inclusion Criteria: * Actively follows at the Children's Hospital of Philadelphia (CHOP) outpatient clinics * SBS arm specific: History of SBS diagnosis. History of short bowel syndrome based on surgical/imaging records. Small bowel is in continuity with some portion of colon * Control arm specific: No history of intestinal pathologies * No or negligible amount (few bites of fiber-containing foods okay) of fiber in tube feeds or by mouth at baseline * Less than 20% calories from oral food not containing fiber while the other 80% may be by enteral and/or parenteral feedings * At least 20% calo…
Interventions
- Dietary SupplementGreen bean puree
Green bean contains both soluble and insoluble fiber, which may have different extent of influence on the gut microbiome. Using a real food rather than a purified fiber such as pectin is more practical and more acceptable to families.
Location
- Children's Hospital of PhiladelphiaPhiladelphia, Pennsylvania