Dietary and Parenteral Nutritional Management of Short Bowel Syndrome with Intestinal Failure in Adults: A Narrative Review
- 1Gastroenterology Unit, Azienda Ospedale-Università of Padova, Department of Surgery, Oncology and Gastroenterology, University of Padova, 35128 Padova, Italy
- 2Clinical Nutrition Unit, Azienda Ospedale-Università of Padova, DIDAS Medicina dei Sistemi, 35128 Padova, Italy
- 3Department of Medicine, University of Padova, 35128 Padova, Italy
Abstract
Short bowel syndrome (SBS) is the leading cause of chronic intestinal failure in adults, arising when the residual small bowel can no longer absorb the macronutrients, water, and electrolytes needed to sustain health without intravenous supplementation. Its management is, at its core, a nutritional problem. This narrative review summarises and critically appraises current evidence and guideline recommendations on the two pillars of that management: dietary (oral/enteral) therapy and parenteral nutritional support. We frame both around the two variables that dominate clinical behaviour, namely residual intestinal anatomy and the phase of intestinal adaptation, and translate them into anatomy-tailored dietary strategies, rational fluid and electrolyte replacement, micronutrient surveillance, and the composition, delivery, and complications of (home) parenteral nutrition. We also position the pharmacological adjuncts, culminating in glucagon-like peptide-2 (GLP-2) analogues, within a stepwise strategy to reduce parenteral support dependence. The goal throughout is a practical, physiology-anchored approach that maximises enteral autonomy and quality of life while preventing the metabolic, hepatic and catheter-related complications of long-term intravenous feeding. The literature was identified through structured but non-systematic searches of PubMed/MEDLINE, Embase and the Cochrane Library, and the nature of the evidence supporting each recommendation, ranging from randomised trials to expert consensus, is indicated throughout the text.
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BibTeX
@article{barberio2026dietary,
title = {{Dietary and Parenteral Nutritional Management of Short Bowel Syndrome with Intestinal Failure in Adults: A Narrative Review}},
author = {Brigida Barberio and Beatrice Varotto and Matteo D’Angelo and Lara Tessari and Gianni Di Lecce and Pietro Pirro and Francesco Cesaroni and Sara Cusano and Luisa Bertin and Fabiana Zingone and Patrizia Burra and Luca Busetto and Edoardo Vincenzo Savarino and Giulia Tognana},
journal = {Nutrients},
year = {2026},
month = oct,
doi = {10.3390/nu18193263},
url = {https://europepmc.org/article/PMC/PMC13666838},
note = {CC BY},
}
RIS
TY - JOUR
TI - Dietary and Parenteral Nutritional Management of Short Bowel Syndrome with Intestinal Failure in Adults: A Narrative Review
AU - Brigida Barberio
AU - Beatrice Varotto
AU - Matteo D’Angelo
AU - Lara Tessari
AU - Gianni Di Lecce
AU - Pietro Pirro
AU - Francesco Cesaroni
AU - Sara Cusano
AU - Luisa Bertin
AU - Fabiana Zingone
AU - Patrizia Burra
AU - Luca Busetto
AU - Edoardo Vincenzo Savarino
AU - Giulia Tognana
PY - 2026
DA - 2026/10/01
JO - Nutrients
DO - 10.3390/nu18193263
UR - https://europepmc.org/article/PMC/PMC13666838
AB - Short bowel syndrome (SBS) is the leading cause of chronic intestinal failure in adults, arising when the residual small bowel can no longer absorb the macronutrients, water, and electrolytes needed to sustain health without intravenous supplementation. Its management is, at its core, a nutritional problem. This narrative review summarises and critically appraises current evidence and guideline recommendations on the two pillars of that management: dietary (oral/enteral) therapy and parenteral nutritional support. We frame both around the two variables that dominate clinical behaviour, namely residual intestinal anatomy and the phase of intestinal adaptation, and translate them into anatomy-tailored dietary strategies, rational fluid and electrolyte replacement, micronutrient surveillance, and the composition, delivery, and complications of (home) parenteral nutrition. We also position the pharmacological adjuncts, culminating in glucagon-like peptide-2 (GLP-2) analogues, within a stepwise strategy to reduce parenteral support dependence. The goal throughout is a practical, physiology-anchored approach that maximises enteral autonomy and quality of life while preventing the metabolic, hepatic and catheter-related complications of long-term intravenous feeding. The literature was identified through structured but non-systematic searches of PubMed/MEDLINE, Embase and the Cochrane Library, and the nature of the evidence supporting each recommendation, ranging from randomised trials to expert consensus, is indicated throughout the text.
SN - 2072-6643
ER -