The microbiome of children with short bowel syndrome

Infants who suffer from necrotizing enterocolitis, a condition we’ve written about on the blog, often must have the dead portion of their intestines surgically removed. Some children who undergo this procedure, as well as others with congenital malformations of the bowel, suffer from a condition called short bowel syndrome (SBS). SBS results when nutrients are unable to properly absorb in the intestines and intravenous feeding is often needed to ensure these children have the nutrients needed to survive. It is thought that the intestinal microbiome plays an important role in the ability to remove children from intravenous feeding, however the microbiome of these children had never previously been mapped.

Scientists in Sweden successfully mapped the microbiome of children with SBS that were diagnosed in the neonatal period. They collected fecal samples from 11 children with SBS and 7 healthy siblings who served as controls for the study. Children that were on parenteral nutrition (PN), or intravenous feeding, had significant intestinal dysbiosis compared to the children who had been weaned off of PN and suffered from a condition called small bowel bacterial overgrowth (SBBO), a condition that is known to prevent weaning off of PN.

In 6 of the 11 patients with SBS, and specifically those still on PN, Enterobacteriacae dominated the guts of these children. While those children who were off PN had more diverse microbiomes than those on PN, only one of those 5 children had diversity levels on the same level of the control individuals without SBS.

This microbial dysbiosis in children with SBS is in line with mappings of individuals with other bowel conditions such as Crohn’s disease and necrotizing enterocolitis. While this study was small in the number of children studied, it was the first to study the microbiome of children with this serious condition. Currently, children with SBS are often given probiotics but the results of this have been conflicting and there are often complications such as septicemia. Future studies will be important to look at how the microbiome can be altered to treat this dysbiosis so that children can be weaned off of parenteral nutrition.


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