Distal Recirculation of Enteral contents Augmented Mechanically (DREAM) Promotes Intestinal Adaptation and Restores Enterohepatic Signaling in Short Bowel Syndrome.

DREAM (Distal Recirculation of Enteral contents Augmented Mechanically) in neonatal pigs with short bowel syndrome (75% resection) restores enterohepatic signaling and prevents hepatic injury, with bilirubin 0.11 vs 5.14 mg/dL.

• Why it matters: Short bowel syndrome causes malabsorption and intestinal failure-associated liver disease, and limited enteral nutrition delivery can impair intestinal adaptation and gut-liver homeostasis.
• What they did: In a randomized study of 20 neonatal pigs, investigators compared EN control, SBS (75% resection), and DREAM, assessing growth, serum biochemistry/cytokines, intestinal morphology/barrier integrity, hepatic histology, and gene expression.
• The result: DREAM prevented hepatic and intestinal injury seen in SBS and enabled 80% macronutrient absorption within 6 hours (P < .0001), supporting restored absorption, mucosal integrity, and gut-liver homeostasis.

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