Ernährung bei Kindern mit Kurzdarmsyndrom

ZUSAMMENFASSUNG

Das pädiatrische Kurzdarmsyndrom als eine Form des chronischen Darmversagens ist eine seltene und schwerwiegende Erkrankung. Durch den Einsatz heimparenteraler Ernährung können Überleben, Wachstum und Entwicklung sichergestellt werden. Jedoch bedeutet die Notwendigkeit eines permanenten zentralvenösen Katheters eine Einschränkung der Lebensqualität und geht mit impliziten Risiken einher wie Katheter-Infektionen, metabolischen Entgleisungen und Hepatopathie. Die orale und enterale Ernährung ist daher von herausragender Bedeutung: erstens zur Förderung der Adaptation des verbliebenen Darmes mit dem primären Behandlungsziel, die parenterale Ernährung reduzieren und schließlich beenden zu können; zweitens, um Risiken und Komplikationen beispielsweise die mit chronischem Darmversagen assoziierte Hepatopathie zu minimieren, und drittens, um die Entwicklung oro-fazialer Fähigkeiten zu fördern zur Vermeidung oraler Aversionen und Essstörungen mit größtmöglicher sozialer Teilhabe und Lebensqualität. Die Betreuung von Kindern mit Kurzdarmsyndrom durch bzw. mit einem spezialisierten Zentrum für Intestinale Rehabilitation verbessert Outcome und Prognose.

ABSTRACT

Paediatric short bowel syndrome as the leading cause of chronic intestinal failure in children is a rare and serious condition. The use of home parenteral nutrition can ensure survival, growth and development. However, the need for a permanent central venous catheter for intravenous nutrition limits quality of life and is associated with implicit risks such as catheter infections, metabolic imbalances and hepatopathy. Oral and enteral nutrition is therefore of paramount importance: firstly, to promote adaptation of the remaining bowel with the primary treatment goal of being able to reduce and eventually discontinue parenteral nutrition by achieving enteral autonomy. Secondly, to minimise risks and complications such as the intestinal failure associated liver disease. And thirdly, to promote the development of oral-facial skills to avoid oral aversions and eating disorders with the greatest possible social participation and quality of life. The care of children with short bowel syndrome by or with a specialised centre for intestinal rehabilitation improves outcome and prognosis.

Schlüsselwörter

Kurzdarmsyndrom - chronisches Darmversagen - Ernährung - intestinale Rehabilitation

Keywords

Short bowel syndrome - chronic intestinal failure - nutrition - intestinal rehabilitation

Publication History

Article published online:
14 December 2022

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