Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Associate professor Jessie Hulst, The Hospital for Sick Children, Canada
- Second opponent: Associate professor Jetta Tuokkola, Helsinki University Hospital, Finland
- Third member and chair of the evaluation committee: Professor II Knut Jørgen Labori, University of Oslo
Chair of the Defence
Professor emeritus Ragnhild Emblem, University of Oslo
Principal Supervisor
Professor Christine Henriksen, University of Oslo
Summary
Intestinal failure is a rare but severe condition in which the gut cannot absorb enough nutrients and fluids to sustain health and growth, necessitating long term parenteral nutrition. While lifesaving, parenteral nutrition carries medical risks and places a substantial burden on children and their families. Gastrointestinal symptoms are common and may limit progression toward enteral nutrition and independence from parenteral support. These symptoms may be linked to dysbiosis of the gut microbiota. Antibiotics are commonly used as treatment, but alternative strategies are needed. Prebiotics, nondigestible food components that selectively stimulate beneficial gut bacteria, may improve microbiota balance, reduce gastrointestinal symptoms, and potentially enhance health related quality of life.
This thesis investigates how nutritional support and gastrointestinal symptoms influence health related quality of life in children with intestinal failure and their families and evaluates prebiotic supplementation as a potential therapeutic approach.
Using baseline data from a cross sectional analysis, health related quality of life was assessed. Parent reported quality of life was markedly reduced compared with healthy peers, whereas children’s self reports did not differ significantly. The need for parenteral nutrition placed a substantial burden on parents and impaired family functioning. Gastrointestinal symptoms were strongly associated with reduced quality of life.
In a randomized controlled trial, prebiotic supplementation resulted in a significant reduction in gastrointestinal symptoms. Microbiota composition was altered, including increases in selected beneficial taxa and transient reductions in potentially pro inflammatory bacteria. Responses varied according to baseline microbiota composition and intestinal anatomy. Prebiotics may therefore benefit a subset of children with intestinal failure and highlight the importance of individualised care.
Additional information
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