Effect of growth hormone in the management of short bowel syndrome in neonates

ABSTRACT

Management of short bowel syndrome is a challenge in the postoperative period due to defect in the absorptive surface area which leads to diarrhea with loss of a large amount of fluids and nutrients that necessitates specific enteral and parenteral nutrition. These manifestations improve when the process of intestinal adaptation starts. There is a controversy about the role of growth hormone in accelerating the process of intestinal adaptation. In this study, 24 patients with short bowel syndrome were divided into two groups. The first group consists of 14 patients received growth hormone and a second group consists of 10 patients that didn't receive growth hormone. In both groups, enteral and parenteral nutrition, loperamide to delay intestinal motility and ranitidine in the first week to decrease gastric hypersecretion were given. The beginning of intestinal adaptation beside histological examination of the intestine was compared in both groups. Growth hormone appeared to have a positive effect on accelerating the intestinal adaptation in short bowel syndrome clinically. The histological examination which was done 3-6 months postoperatively revealed increase of the length of the villi with thickened mucosa in both groups without significant difference because, most probably, the histological study was done after the intestinal adaptation has started in both groups