小腸移植後患者に対する食事指導‘管理栄養士とボランティアによる食育を通して’

抄録

【Introduction】Besides life support, it is essential that the nutritional management of infants with small bowel failure who are dependent on total parenteral nutrition from soon after birth takes into account their growth and development. However, since long-term dependence on TPN causes a range of complications, small bowel transplantation is often indicated. Becuase there are no markers of rejection following small bowel transplantation, monitoring of the balance between daily oral intake and excretory volume is important.
【Purpose】We reviewed the content of dietary guidance provided by dieticians and the dietary education provided by student volunteers （Nuigurumi byoin,） for a patient who underwent living-donor small bowel transplantation at our hospital.
【Case Report】A living-donor small bowel transplantation was performed to treat a hypoganglionosis 9-year-old boy, with the mother as the donor.
【Intervention and Outcome】Preoperative intervention was provided by a dietician, and the Nuigurumi Byoin provided dietary education. They worked together to evaluate and implement an appropriate posttransplantation diet that carefully considered the underlying condition and biased preferences. The patient was able to understand the need for dietary limitations and a balanced diet postoperatively and is currently capable of observing abdominal symptoms and the volume of intestinal fluid excreted after meals and of adjusting his choice of food accordingly.
【Discussion】The provision of dietary education, which includes information on altering food habits based on the state of their health, is meaningful for small bowel transplant patients, who have few opportunities to receive guidance and education on diet from an early age for medical reasons.
【Conclusion】Dietary education by the Nuigurumi Byoin was provided as participatory-style guidance tailored to the individual circumstances of a child who underwent small bowel transplantation. This type of guidance has the potential to exert a lasting effect on a posttransplantation lifestyle.