ESPEN has elaborated guidelines for management of patients with short bowel syndrome (SBS). Those one include dietary recommendations that are difficult to put into practice. Our aim is to evaluate on a cohort of short bowel syndrome the real life food intakes in terms of quality and amount.

It is a prospective study including the consecutive adult patients with short bowel syndrome (remaining small bowel length ≤ 200 cm) who had their outpatient visit for regular nutritional monitoring between February 6th, 2018 and May 29th, 2018. As usual, oral intake was evaluated by one of the experimented dietitians involved in our multidisciplinary team. Sixty nine patients (M: 39%; F: 61%), with a mean age of 58.8 years (±19.4) were included. The mean BMI was 22.6 kg/m2 (±5.1). The mean remaining small bowel length was 99.4 cm (±54.4). Thirty nine patients (49%) require Home Parenteral Nutrition. Oral intake was evaluated using three days food diary. Total oral intake (percentage of carbohydrates, proteins and lipids), oral rehydration solution (ORS) consumption and amount of fibers were analyzed. The energy expenditure was calculated with Harris and Benedict formulae.

Patients with intestinal failure (n=39) required 4.6 ± 1.9 infusions per week, with a volume of 10 909 ± 9 187 ml per week and 7 030 ± 4 559 kcal per week. Six/15 patients with jejunostomy consumed ORS regularly with a mean intake of 9 041 ± 3 572 ml per week. Oral proteins/glucids/proteins(%) intake is respectively for patients with jejunostomy and patients with anastomosis 16.9/ 57/ 34.7 and 15.2/51.5/33.1. Guidelines recommende 20-30% of proteins for all patients, 40-50% of glucids for patients with jejunostomy and 50-60% for patients with anastomosis and 40% of lipids for jejunostomy and 20-30% for patients with anastomosis.

In a large SBS cohort patients with intestinal failure or intestinal insufficiency, even with dedicated dieticians, patients whatever the intestinal anatomy have the same profile of ingesta in terms of quantity and amount of macronutrients. Interestingly, in our population, 40% of patients with jejunostomy have a regular and consistent ORS intake. That’s probably due to a very important engagement of dietician and physician to explain the importance of drinking specific beverage in these patients. So, we can suppose, that a more adapted, dietetic training program could improve the global adhesion of recommended diet for SBS patients.