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"Jiyoung Song"

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"Jiyoung Song"

Case Report

Exocrine pancreatic insufficiency as an overlooked cause of chronic diarrhea after Billroth II gastrectomy identified through nutrition-focused assessment: a case report
Mijin Kang, Dal Lae Ju, Sookyoung Kim, Jiyoung Song, Youngran Kim
Clin Nutr Res 2026;15(2):117-121.   Published online April 30, 2026
DOI: https://doi.org/10.7762/cnr.2026.0012
Postgastrectomy diarrhea is often attributed to dumping syndrome or functional changes; however, exocrine pancreatic insufficiency (EPI) from anatomical and physiological alterations may be an underrecognized cause of malabsorption and nutritional decline. Because EPI symptoms are often nonspecific, it may remain undiagnosed and lead to progressive malnutrition if untreated. This case report describes severe EPI identified via nutrition-focused assessment in a patient with persistent diarrhea after Billroth II gastrectomy, and the clinical response to pancreatic enzyme replacement therapy (PERT). A patient with a history of subtotal gastrectomy with Billroth II reconstruction for gastric cancer presented with chronic diarrhea, steatorrhea, weight loss, and hypoalbuminemia. Repeated endoscopic and radiologic evaluations identified no structural cause of diarrhea. Comprehensive nutrition-focused assessment indicated fat malabsorption, and fecal pancreatic elastase was markedly reduced (23.8 µg/g), confirming severe EPI. PERT with pancreatin containing 25,000 units of lipase (Norzyme) was initiated with meals. Posttreatment, steatorrhea resolved and bowel movements normalized without dietary fat restriction. Serum albumin levels subsequently normalized, and body weight returned to the normal range, indicating improved nutritional status. This case emphasizes the clinical value of nutrition-focused assessment in identifying treatable causes of malabsorption, such as EPI, in patients with persistent postgastrectomy diarrhea.
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Original Article

Dietary management of pediatric patients with kidney disease: recommendations by the Korean Society of Pediatric Nephrology and the Korean Society of Clinical Nutrition
Yo Han Ahn, Hee Gyung Kang, Jiyoung Song, Sangmi Han, Eujin Park, Jin-Soon Suh, Jeong Yeon Kim, Min Ji Park, Keum Hwa Lee, Seon Hee Lim, Kyeong Hun Shin, Hyunji Ko, Hyun Joo Lee, Eunyoung Jeong, Jinsu Kim, Sohyun Park, Eonju Choi, Yuri Seo, Kyooyung Oh, Jin Kyoung Kim, Hyun Kyung Lee
Clin Nutr Res 2026;15(1):1-11.   Published online January 31, 2026
DOI: https://doi.org/10.7762/cnr.2025.0033
Pediatric kidney disease has a lower prevalence than other pediatric conditions and has a notably different etiology from kidney diseases occurring in adults. Furthermore, the pediatric population is unique in that they experience ongoing growth and development, distinguishing them from adult patients. Consequently, pediatric patients with kidney disease require a more specialized and meticulous nutritional management plan compared with adult patients. To address this need and promote optimal dietary practices for pediatric patients with kidney disease, pediatric nephrologists from the Korean Society of Pediatric Nephrology and nutritionists from the Korean Society of Clinical Nutrition have collaborated to formulate nutritional guidelines specifically tailored to Korean dietary patterns. These guidelines offer detailed, nutrient-specific recommendations regarding the consumption of energy, protein, calcium, phosphorus, and potassium while providing practical, culturally relevant guidance intended to support both pediatric patients and their caregivers.
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Case Report
Nutritional Management for Chronic Kidney Disease Undergoing Bariatric Surgery: A Case Report
Yunjung Choi, Jiyoung Song, Jeong Hyun Lim, Dal Lae Ju
Clin Nutr Res 2024;13(4):238-243.   Published online October 24, 2024
DOI: https://doi.org/10.7762/cnr.2024.13.4.238

Nutrition support is an essential aspect of treatment after bariatric surgery (BS). A high-protein diet with an intake of up to 1.5 g/kg of ideal body weight (IBW) per day is recommended to minimize loss of lean body mass after BS. However, protein intake recommendations may need to be adjusted for patients with compromised renal function, necessitating an individualized approach tailored to each patient’s clinical status. This case report aimed to demonstrate nutritional evaluation, education, and counseling for a male patient with chronic kidney disease (CKD) who underwent BS one year after surgery. Following BS, the patient adhered to the standard Seoul National University Hospital BS diet protocol. Considering his postoperative renal function, protein requirement was set at 1.0 g/kg of IBW. A total of 10 individualized nutritional counseling sessions were conducted according to renal function and complications. One year after BS, he successfully lost weight with % excess weight loss of 93%, maintained CKD stage 3, reduced prescription of oral hypoglycemic agent, improved glycated hemoglobin levels, and improved eating habits significantly. Thus, individualized nutrition intervention is important for supporting patients with CKD to reach their goal weight after BS, improve nutritional status, and prevent post-operative complications.

Citations

Citations to this article as recorded by  
  • Recurrent Weight Gain after Metabolic Bariatric Surgery (MBS): Emerging Insights on Kidney Function
    Seyed Amirhossein Fazeli, Mamdouh I. Elamy, Hamed Soleimani samarkhazan
    Obesity Surgery.2026; 36(1): 319.     CrossRef
  • 1,082 View
  • 20 Download
  • 1 Crossref