Fiber Food Introduction in Pediatric Short Bowel Syndrome

Eligibility Criteria

• * Actively follows at the Children's Hospital of Philadelphia (CHOP) outpatient clinics
• * SBS arm specific: History of SBS diagnosis. History of short bowel syndrome based on surgical/imaging records. Has ileocecal resection (No ICV) and small bowel is in continuity with some portion of colon
• * Control arm specific: No history of intestinal pathologies
• * No or negligible amount (few bites of fiber-containing foods okay) of fiber in tube feeds or by mouth at baseline
• * Less than 20% calories from oral food not containing fiber while the other 80% may be by enteral and/or parenteral feedings
• * At least 20% calories from fiber-free formula taken orally or via tube
• * Antibiotic use is allowed, however, should be on a stable regimen of antibiotics starting from 2 weeks prior to intervention until end of study or end of week 3 whichever is sooner. Instances of antibiotic use for brief courses (7-10 days) as long as sample collection is scheduled to be at least a week from the end date of antibiotics.
• * Previous history of fiber introduction failure is acceptable as long as clinically stable at the time of recruitment
• * Fiber supplementation is appropriate per primary physician
• * If subject is unable to provide full set of samples, they will still be enrolled
• * SBS Arm specific: No diagnosis of SBS. No history of ICV resection.
• * Control Arm specific: has baseline intestinal diseases
• * Small bowel and colon not in continuity (Ex: presence of ileostomy or jejunostomy)
• * \>5% changes in percentage of calories from oral nutrition (PO), enteral nutrition (EN) and/or parenteral nutrition (PN) during the intervention
• * Addition/discontinuation/significant alteration to antibiotics regimen during study period
• * Primary physician does not think fiber supplementation is appropriate clinically