Micronutrient Status in Patients with Short Bowel Syndrome Weaned off Parenteral Support.

Background/

Objectives

In short bowel syndrome adults (SBS), about 50% of patients on parenteral support (PS) are weaned off. However, micronutrient deficiency prevalence has never been studied in weaned patients. We aimed to assess the prevalence of micronutrient depletions and potential risk factors, more than a year after PS weaning.

Methods

A retrospective study was conducted on our 161 weaned SBS patients between January 2011 and December 2021. Only 42 of them had an assessment of their plasma micronutrient status more than a year after PS weaning.

Results

40/42 patients had at least one micronutrient depletion, with an average of 4.0 ± 1.9 depletions per patient. Depletions in vitamins D, E, selenium, copper, and zinc were the most frequent, present for >50% of patients. In 75% of cases, patients depleted in vitamin B12 and D were already supplemented. Long-term proton pump inhibitor (PPI) use and duration on PS was associated with ≥ three depletions (p = 0.02). A daily mean of the total energy infused per week > 20 kcal/kg/day at the time of weaning was associated with more depletions (5.8 ± 1.6 vs. 3.7 ± 1.7 depletions, p = 0.02). Other factors (digestive anatomy, particularly SBS type, or associated chronic disease) were not predictive of depletion.

Conclusions

Nearly all patients with SBS have at least one micronutrient depletion after PS withdrawal. This study suggests that a long-term monitoring of micronutrients status is needed for SBS patients weaned off PS. A larger-scale study would be necessary to generalize these results.