Effect of growth hormone, glutamine, and enteral nutrition on intestinal adaptation in patients with short bowel syndrome

Background/aims: In the management of short bowel syndrome, the benefits of treatment with growth hormone, glutamine, and enteral nutrition for intestinal adaptation is still controversial. The aim of the current study was to determine whether growth hormone, glutamine, and enteral nutrition had positive effect on intestinal adaptation. Materials and Method: Twelve patients with short bowel syndrome (small-bowel remnant length, 59 +/- 9 cm; mean +/- SEM) received growth hormone (0.05 mg/kg/day), oral glutamine (30 g/day), plus enteral nutrition for 4 weeks. Intestinal absorptive capacity and biochemical parameters were investigated before treatment and after treatment. Body composition was determined by bioelectric impedance analysis. Result: All patients completed the treatment. Intestinal absorptive capacity and plasma levels of proteins were significantly improved after treatment. Body weight, lean body mass, total body water, and body cell mass also increased without any major adverse effects. At the 3-month follow-up, the nutritional status of patients was also well maintained, and there was no death during this period. Conclusion: Four weeks of intestinal rehabilitation therapy significantly improved intestinal absorption if appropriate patient with short bowel syndrome was selected.