Fiber Food Introduction in Pediatric Short Bowel Syndrome

Inclusion 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. 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

Exclusion Criteria:

* SBS Arm specific: No diagnosis of SBS.
* 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