Short Bowel Syndrome
Conditions
Keywords
Sarcopenia, short bowel syndrome, adaptation
Brief summary
Sarcopenia or the loss of skeletal muscle is highly prevalent in many diseases, including short bowel syndrome (SBS). While adaptation is more likely in SBS patients with a colon-in-continuity, the consequences and underlying mechanisms are unclear. An overabundance of fecal Lactobacillus was found but not yet linked to adaptation or sarcopenia. The objectives are to study the evolution of sarcopenia and the link with intestinal adaptation in SBS.
Detailed description
Patients with short bowel syndrome (SBS) will be screened and included in longitudinal or cross-sectional studies if eligible. The longitudinal study will follow patients with type 1 SBS (enterostomy) before and every 3 months after continuity surgery for 1 year. Cross-sectional studies will follow patients with type 2 or 3 SBS (jejunocolonic or -ileal anastomosis) for 1 year (every 3 months during the first 2 years after continuity surgery or every 6 months after). Study visits will include clinical examination, nutritional assessment, endoscopy with biopsies and/or intestinal absorption assessment planned as part of routine follow-up. In addition, questionnaires will be completed (GPAQ, SarQoL, EQ-5D -3L, SF36), with collection of stool (for routine and research) and urine samples (for research). The objective are to study the evolution of sarcopenia and the link with intestinal adaptation in SBS. The results may identify metabolic or microbial biomarkers and predictors of nutritional optimisation in SBS, which is a complex and costly orphan disease.
Interventions
OTHERquestionnaires with collection of stool and urine
questionnaires will be completed (GPAQ, SarQoL, EQ-5D-3L, SF36), with collection of stool (for care and research) and urine
Sponsors
Assistance Publique - Hôpitaux de Paris
Study design
Observational model
OTHER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥18 years old * SBS diagnosis validated by small bowel length and either type 1 (enterostomy), type 2 or 3 (jejuno-colic or -ileal anastomosis) * Patient not objecting to the collection of personal data as part of the study
Exclusion criteria
* Pregnancy * Remaining hail length unknown * Patient expressing opposition to participating in the cohort * Patients who are unable to express themselves
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Evolution of sarcopenia | at 12 months | Changes in muscle strength (Jamar's dynamometer) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Impact of sarcopenia | at 12 months | Changes in questionnaire of quality of life SarQoL |
| Link with intestinal adaptation | at 12 months | Number of changes in histological markers of adaptation in relation to sarcopenia. Each of these elements can be considered as a chang : crypt depths, villi length, immune cells. |
| Quantification of intestinal adsorption and its link with intestinal adaptation | at 12 months | Changes in intestinal absorption balance markers of adaptation in relation to sarcopenia: digestive losses in fat, proteins, carbohydrates and total energy. These elements will be quantified by biological assessements. |
| Quantification of urinary metabolite linked with sarcopenia | at 12 months | Changes in urinary markers of fermentation in relation to sarcopenia (metagenomic sequencing) |
| Quantification of fecal metabolite linked with sarcopenia | at 12 months | Changes in fecal markers of fermentation in relation to sarcopenia (mass spectrometry) |
Countries
France
Outcome results
None listed