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Development of a Gut Model for Analyzing Impact of Surgical Intervention in Short Bowel Syndrome.

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Title: Development of a Gut Model for Analyzing Impact of Surgical Intervention in Short Bowel Syndrome.
Authors: Rosenberg M; Department of General Surgery, University of Massachusetts Chan Medical School - Baystate, Springfield, Massachusetts. Electronic address: Meagan.rosenberg@baystatehealth.org., Roberson M; Goldfinch Sensor Technologies and Analytics, LLC, Cary, North Carolina., Patel R; Goldfinch Sensor Technologies and Analytics, LLC, Cary, North Carolina., Chang E; Goldfinch Sensor Technologies and Analytics, LLC, Cary, North Carolina., Chang C; Goldfinch Sensor Technologies and Analytics, LLC, Cary, North Carolina., Tirabassi MV; Department of Surgery, Division of Pediatric Surgery, University of Massachusetts Chan Medical School-Baystate, Springfield, Massachusetts.
Source: The Journal of surgical research [J Surg Res] 2026 Jun; Vol. 322, pp. 282-289. Date of Electronic Publication: 2026 Apr 15.
Publication Type: Journal Article
Language: English
Journal Info: Publisher: Academic Press Country of Publication: United States NLM ID: 0376340 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1095-8673 (Electronic) Linking ISSN: 00224804 NLM ISO Abbreviation: J Surg Res Subsets: MEDLINE
Imprint Name(s): Publication: New York, NY : Academic Press
Original Publication: Philadelphia [etc.]
MeSH Terms: Short Bowel Syndrome*/surgery , Short Bowel Syndrome*/physiopathology , Short Bowel Syndrome*/metabolism , Short Bowel Syndrome*/pathology , Intestinal Absorption* , Models, Biological*, Glucose/metabolism ; Humans ; Child, Preschool ; Infant, Newborn ; Adolescent
Abstract: Introduction: Studying surgical intervention on nutrient absorption in short bowel syndrome (SBS) is challenging due to disease rarity. Animal models are expensive, time consuming, and fail to accurately mimic human SBS physiology. We hypothesized that a parameterized gut model could accurately quantify glucose absorption as intestinal length and diameter are altered using a neonatal, 2-year-old, and adolescent subject.
Methods: To analyze total bolus movement and nutrient uptake, we created an analytic expression using the Darcy-Weisbach equation. Glucose absorption was calculated for an average adolescent, 2-year-old, and neonate. Bowel length was decreased to model SBS and bowel diameter adjusted up to 2-times the normal size to simulate maladaptive dilation. Absorption, abs, is predicted in terms of diameter, Db, and length, Lb, as abs∝Lb3/2/Db5/2.
Results: Bowel diameter, length, and SBS length were determined as follows: adolescent: 23 mm diameter, 575 cm length, 200 cm SBS; 2-year-old: 15 mm diameter, 350 cm length, 175 cm SBS; neonate: 12 mm diameter, 250 cm length, 125 cm SBS. Absorption was estimated at 80 mmol/h/25 cm with a 140 mM glucose bolus. At full length, adolescent and child absorption remained 100% until 1.5x normal bowel diameter. Neonate absorption declined at 1.1x diameter. In SBS with no dilation, absorption was 54% (adolescent), 98% (child), and 45% (neonate). All three SBS models declined along a negative exponential curve with dilation without a plateau of stable absorption.
Conclusions: Our model suggests that neonates with SBS are highly susceptible to malabsorption with even a low degree of dilation. Earlier autologous reconstruction may be beneficial. We hope this platform will facilitate future testing of surgical interventions to optimize procedure and timing.
(Copyright © 2026 Elsevier Inc. All rights reserved.)
Contributed Indexing: Keywords: Level 5 evidence; Nutrition; Original research; Pediatric; Short bowel syndrome; Small intestine; Surgery; Virtual modeling
Substance Nomenclature: IY9XDZ35W2 (Glucose)
Entry Date(s): Date Created: 20260416 Date Completed: 20260715 Latest Revision: 20260715
Update Code: 20260715
DOI: 10.1016/j.jss.2026.03.057
PMID: 41990643
Database: MEDLINE
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  Data: Development of a Gut Model for Analyzing Impact of Surgical Intervention in Short Bowel Syndrome.
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  Data: <searchLink fieldCode="AU" term="%22Rosenberg+M%22">Rosenberg M</searchLink>; Department of General Surgery, University of Massachusetts Chan Medical School - Baystate, Springfield, Massachusetts. Electronic address: Meagan.rosenberg@baystatehealth.org.<br /><searchLink fieldCode="AU" term="%22Roberson+M%22">Roberson M</searchLink>; Goldfinch Sensor Technologies and Analytics, LLC, Cary, North Carolina.<br /><searchLink fieldCode="AU" term="%22Patel+R%22">Patel R</searchLink>; Goldfinch Sensor Technologies and Analytics, LLC, Cary, North Carolina.<br /><searchLink fieldCode="AU" term="%22Chang+E%22">Chang E</searchLink>; Goldfinch Sensor Technologies and Analytics, LLC, Cary, North Carolina.<br /><searchLink fieldCode="AU" term="%22Chang+C%22">Chang C</searchLink>; Goldfinch Sensor Technologies and Analytics, LLC, Cary, North Carolina.<br /><searchLink fieldCode="AU" term="%22Tirabassi+MV%22">Tirabassi MV</searchLink>; Department of Surgery, Division of Pediatric Surgery, University of Massachusetts Chan Medical School-Baystate, Springfield, Massachusetts.
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  Data: <searchLink fieldCode="JN" term="%220376340%22">The Journal of surgical research</searchLink> [J Surg Res] 2026 Jun; Vol. 322, pp. 282-289. <i>Date of Electronic Publication: </i>2026 Apr 15.
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  Data: <i>Publisher: </i><searchLink fieldCode="PB" term="%22Academic+Press%22">Academic Press </searchLink><i>Country of Publication: </i>United States <i>NLM ID: </i>0376340 <i>Publication Model: </i>Print-Electronic <i>Cited Medium: </i>Internet <i>ISSN: </i>1095-8673 (Electronic) <i>Linking ISSN: </i><searchLink fieldCode="IS" term="%2200224804%22">00224804 </searchLink><i>NLM ISO Abbreviation: </i>J Surg Res <i>Subsets: </i>MEDLINE
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  Data: <searchLink fieldCode="MM" term="%22Short+Bowel+Syndrome%22">Short Bowel Syndrome*</searchLink>/<searchLink fieldCode="MM" term="%22Short+Bowel+Syndrome+surgery%22">surgery</searchLink> <br /><searchLink fieldCode="MM" term="%22Short+Bowel+Syndrome%22">Short Bowel Syndrome*</searchLink>/<searchLink fieldCode="MM" term="%22Short+Bowel+Syndrome+physiopathology%22">physiopathology</searchLink> <br /><searchLink fieldCode="MM" term="%22Short+Bowel+Syndrome%22">Short Bowel Syndrome*</searchLink>/<searchLink fieldCode="MM" term="%22Short+Bowel+Syndrome+metabolism%22">metabolism</searchLink> <br /><searchLink fieldCode="MM" term="%22Short+Bowel+Syndrome%22">Short Bowel Syndrome*</searchLink>/<searchLink fieldCode="MM" term="%22Short+Bowel+Syndrome+pathology%22">pathology</searchLink> <br /><searchLink fieldCode="MM" term="%22Intestinal+Absorption%22">Intestinal Absorption*</searchLink> <br /><searchLink fieldCode="MM" term="%22Models%2C+Biological%22">Models, Biological*</searchLink><br /><searchLink fieldCode="MH" term="%22Glucose%22">Glucose</searchLink>/<searchLink fieldCode="MH" term="%22Glucose+metabolism%22">metabolism</searchLink> ; <searchLink fieldCode="MH" term="%22Humans%22">Humans</searchLink> ; <searchLink fieldCode="MH" term="%22Child%2C+Preschool%22">Child, Preschool</searchLink> ; <searchLink fieldCode="MH" term="%22Infant%2C+Newborn%22">Infant, Newborn</searchLink> ; <searchLink fieldCode="MH" term="%22Adolescent%22">Adolescent</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Introduction: Studying surgical intervention on nutrient absorption in short bowel syndrome (SBS) is challenging due to disease rarity. Animal models are expensive, time consuming, and fail to accurately mimic human SBS physiology. We hypothesized that a parameterized gut model could accurately quantify glucose absorption as intestinal length and diameter are altered using a neonatal, 2-year-old, and adolescent subject.<br />Methods: To analyze total bolus movement and nutrient uptake, we created an analytic expression using the Darcy-Weisbach equation. Glucose absorption was calculated for an average adolescent, 2-year-old, and neonate. Bowel length was decreased to model SBS and bowel diameter adjusted up to 2-times the normal size to simulate maladaptive dilation. Absorption, abs, is predicted in terms of diameter, D<subscript>b</subscript>, and length, L<subscript>b</subscript>, as abs∝L<subscript>b</subscript><superscript>3/2</superscript>/D<subscript>b</subscript><superscript>5/2</superscript>.<br />Results: Bowel diameter, length, and SBS length were determined as follows: adolescent: 23 mm diameter, 575 cm length, 200 cm SBS; 2-year-old: 15 mm diameter, 350 cm length, 175 cm SBS; neonate: 12 mm diameter, 250 cm length, 125 cm SBS. Absorption was estimated at 80 mmol/h/25 cm with a 140 mM glucose bolus. At full length, adolescent and child absorption remained 100% until 1.5x normal bowel diameter. Neonate absorption declined at 1.1x diameter. In SBS with no dilation, absorption was 54% (adolescent), 98% (child), and 45% (neonate). All three SBS models declined along a negative exponential curve with dilation without a plateau of stable absorption.<br />Conclusions: Our model suggests that neonates with SBS are highly susceptible to malabsorption with even a low degree of dilation. Earlier autologous reconstruction may be beneficial. We hope this platform will facilitate future testing of surgical interventions to optimize procedure and timing.<br /> (Copyright © 2026 Elsevier Inc. All rights reserved.)
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  Data: <i>Keywords: </i>Level 5 evidence; Nutrition; Original research; Pediatric; Short bowel syndrome; Small intestine; Surgery; Virtual modeling
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  Data: 10.1016/j.jss.2026.03.057
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  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1016/j.jss.2026.03.057
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        StartPage: 282
    Subjects:
      – SubjectFull: Glucose metabolism
        Type: general
      – SubjectFull: Humans
        Type: general
      – SubjectFull: Child, Preschool
        Type: general
      – SubjectFull: Infant, Newborn
        Type: general
      – SubjectFull: Adolescent
        Type: general
      – SubjectFull: Short Bowel Syndrome surgery
        Type: general
      – SubjectFull: Short Bowel Syndrome physiopathology
        Type: general
      – SubjectFull: Short Bowel Syndrome metabolism
        Type: general
      – SubjectFull: Short Bowel Syndrome pathology
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      – SubjectFull: Intestinal Absorption
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      – SubjectFull: Models, Biological
        Type: general
    Titles:
      – TitleFull: Development of a Gut Model for Analyzing Impact of Surgical Intervention in Short Bowel Syndrome.
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            NameFull: Rosenberg M
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            NameFull: Roberson M
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            NameFull: Chang E
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              Text: 2026 Jun
              Type: published
              Y: 2026
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              Value: 322
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            – TitleFull: The Journal of surgical research
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