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Nutrition for the Practicing Pediatric Clinician: Nutrition Support Challenges in the Intestinal Failure Patient (NPPC-2019)

Mar 23 | 12:00PM - 4:00PM

Pre-Conference Course

Nutrition for the Practicing Pediatric Clinician: Nutrition Support Challenges in the Intestinal Failure Patient (NPPC-2019)

Patients with intestinal failure (IF) represent a challenging group. Their nutrition support and management need to be tailored based on the bowel segment resected, the amount of resection as well as underlying disease etiology. There is also ongoing debate for intestinal lengthening procedures and their timing for maximizing nutrient absorption. Enteral or parenteral nutrition support and their respective percentages to promote parenteral nutrition autonomy as well as the optimal surgical procedures to enable enteral nutrition delivery like gastrostomy / gastro-jejonostomy or jejunostomy tube and bolus vs continuous feeds present significant challenges. Challenges also remain in treating small bowel bacterial overgrowth as well as instituting gut motility modulators in such patients. Recent data also presents new evidence of alteration in nutrient absorption and assimilation based on influences by the gut microbiota, bile acids and systemic effects modulated by downstream targets with key gut luminal receptor activation. This preconference will present current evidence supporting clinical practices and highlight potential pitfalls in the management of this patient population.

  1. Identify key pathophysiological changes affecting nutrition status based on the site and amount of bowel segment resected
  2. Critically examine the current indications, timing, and nutritional consequences of bowel lengthening and other surgical procedures for patients with intestinal failure
  3. Discuss implications of variances in enteral feeding like continuous vs bolus feeding, type of formula, route of nutrition delivery
  4. Describe various medical therapies and the role of nutritional supplements (probiotics, pre-biotics, fiber) offered to improve enteral feeding tolerance with a goal of enteral autonomy
  5. Summarize current basic and translational research alluding to the role of gut microbiota, bile acids and key gut signaling effecting nutrition outcomes in patients with intestinal failure

Overview of the Strategies for Enteral Autonomy
Jeffrey Rudolph, MD  

Thinking Ahead: Nutrition Deficiencies in Patients with Short Bowel Syndrome
Samuel Kocoshis, MD  

Route and Type of Enteral Nutrition and Enteral Supplements
Gail Cresci, PhD, RD, LD, CNSC

Small Bowel Bacterial Overgrowth and Motility Problems
Valeria Cohran, MD

Challenges in the Home Care of the Intestinal Failure Patient
Beth Lyman, RN, MSN, CNSC

Psychosocial Challenges in the Care of Patients with Intestinal Failure
Rebecca Johnson, PhD

Overview of Surgical Techniques for Short Bowel Syndrome and Intestinal Rehabilitation
Dave Mercer, MD, PhD, FRCS

New Horizons: Bugs, Drugs and Biomarkers in Intestinal Rehabilitation and Live Injury – From the Lab to the Clinic
Ajay Jain, MD


Charlene Compher, PhD, RD, CNSC, LDN, FAND, FASPEN
Timothy Sentongo, MD

LEARNING LEVEL: Intermediate
UAN: JA0002345-0000-19-001-L01-P
CE CREDIT: 4 hours