{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T01:53:45Z","timestamp":1788054825034,"version":"build-2784847793"},"reference-count":189,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,1,12]],"date-time":"2024-01-12T00:00:00Z","timestamp":1705017600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Many patients undergo small bowel and colon surgery for reasons related to malignancy, inflammatory bowel disease (IBD), mesenteric ischemia, and other benign conditions, including post-operative adhesions, hernias, trauma, volvulus, or diverticula. Some patients arrive in the operating theatre severely malnourished due to an underlying disease, while others develop complications (e.g., anastomotic leaks, abscesses, or strictures) that induce a systemic inflammatory response that can increase their energy and protein requirements. Finally, anatomical and functional changes resulting from surgery can affect either nutritional status due to malabsorption or nutritional support (NS) pathways. The dietitian providing NS to these patients needs to understand the pathophysiology underlying these sequelae and collaborate with other professionals, including surgeons, internists, nurses, and pharmacists. The aim of this review is to provide an overview of the nutritional and metabolic consequences of different types of lower gastrointestinal surgery and the role of the dietitian in providing comprehensive patient care. This article reviews the effects of small bowel resection on macronutrient and micronutrient absorption, the effects of colectomies (e.g., ileocolectomy, low anterior resection, abdominoperineal resection, and proctocolectomy) that require special dietary considerations, nutritional considerations specific to ostomized patients, and clinical practice guidelines for caregivers of patients who have undergone a surgery for local and systemic complications of IBD. Finally, we highlight the valuable contribution of the dietitian in the challenging management of short bowel syndrome and intestinal failure.<\/jats:p>","DOI":"10.3390\/nu16020246","type":"journal-article","created":{"date-parts":[[2024,1,12]],"date-time":"2024-01-12T11:43:53Z","timestamp":1705059833000},"page":"246","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Metabolic and Nutritional Issues after Lower Digestive Tract Surgery: The Important Role of the Dietitian in a Multidisciplinary Setting"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5633-6780","authenticated-orcid":false,"given":"Alejandra","family":"Utrilla Fornals","sequence":"first","affiliation":[{"name":"Department of Digestive Surgery, University Hospital Miguel Servet, 50009 Zaragoza, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristian","family":"Costas-Batlle","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics, Bradford Teaching Hospitals NHS Foundation Trust, Bradford BD9 6RJ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Medlin","sequence":"additional","affiliation":[{"name":"City Dietitians, London WC2E 7PP, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Menj\u00f3n-Lajusticia","sequence":"additional","affiliation":[{"name":"Gastroenterology, Hepatology and Nutrition Unit, University Hospital San Jorge, 22004 Huesca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Cisneros-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Faculty of Health and Sport Sciences, University of Zaragoza, 22002 Huesca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Saura-Carmona","sequence":"additional","affiliation":[{"name":"Faculty of Health and Sport Sciences, University of Zaragoza, 22002 Huesca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7676-9842","authenticated-orcid":false,"given":"Miguel A.","family":"Montoro-Huguet","sequence":"additional","affiliation":[{"name":"Gastroenterology, Hepatology and Nutrition Unit, University Hospital San Jorge, 22004 Huesca, Spain"},{"name":"Faculty of Health and Sport Sciences, University of Zaragoza, 22002 Huesca, Spain"},{"name":"Department of Medicine, Faculty of Health and Sport Sciences, University of Zaragoza, 22002 Huesca, Spain"},{"name":"Aragon Health Research Institute (IIS Aragon), University of Zaragoza, 22002 Huesca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1136\/bmj.323.7316.773","article-title":"Early enteral feeding versus \u201cnil by mouth\u201d after gastrointestinal surgery: Systematic review and meta-analysis of controlled trials","volume":"323","author":"Lewis","year":"2001","journal-title":"BMJ"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1136\/bmj.323.7316.761","article-title":"Postoperative starvation after gastrointestinal surgery. 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