scholarly journals Independence From Parenteral Nutrition and Intravenous Fluid Support During Treatment With Teduglutide Among Patients With Intestinal Failure Associated With Short Bowel Syndrome

2016 ◽  
Vol 41 (6) ◽  
pp. 946-951 ◽  
Author(s):  
Kishore R. Iyer ◽  
Marek Kunecki ◽  
Joseph I. Boullata ◽  
Ken Fujioka ◽  
Francisca Joly ◽  
...  
Keyword(s):  
Parenteral Nutrition ◽  
Short Bowel Syndrome ◽  
Intestinal Failure ◽  
Intravenous Fluid ◽  
Short Bowel

scholarly journals Short bowel syndrome in infancy: recent advances and practical management

2020 ◽  
pp. flgastro-2020-101457
Author(s):  
Elena Cernat ◽  
Chloe Corlett ◽  
Natalia Iglesias ◽  
Nkem Onyeador ◽  
Julie Steele ◽  
...  
Keyword(s):  
Parenteral Nutrition ◽  
Short Bowel Syndrome ◽  
Intestinal Adaptation ◽  
Intestinal Failure ◽  
Rare Condition ◽  
Oral Feeding ◽  
Short Bowel ◽  
Intestinal Continuity ◽  
Gastrointestinal Reconstruction ◽  
Lipid Reduction

Short bowel syndrome (SBS) is a rare condition characterised by extensive loss of intestinal mass secondary to congenital or acquired disease. The outcomes are determined by dependency on parenteral nutrition (PN), its possible complications and factors that influence intestinal adaptation. In order to achieve the best results, patients should be managed by a specialised multidisciplinary team with the aims of promoting growth and development, stimulating intestinal adaptation and preventing possible complications. This involves timely surgical management aimed at rescuing maximum bowel length and eventually re-establishing intestinal continuity where appropriate. A combination of enteral and parenteral nutrition needs to be targeted towards maintaining a balance between fulfilling the nutritional and metabolic needs of the child while preventing or at least minimising potential complications. Enteral nutrition and establishment of oral feeding play a fundamental role in stimulating bowel adaptation and promoting enteral autonomy. Other measures to promote enteral autonomy include the chyme recycling in patients where bowel is not in continuity, autologous gastrointestinal reconstruction and pharmacological treatments, including promising new therapies like teduglutide. Strategies such as lipid reduction, changing the type of lipid emulsion and cycling PN are associated with a reduction in the rates of intestinal failure–associated liver disease. Even though vast improvements have been made in the surgical and medical management of SBS, there is still lack of consensus in many aspects and collaboration is essential.

scholarly journals Randomised placebo-controlled trial of teduglutide in reducing parenteral nutrition and/or intravenous fluid requirements in patients with short bowel syndrome

Gut ◽  
2011 ◽  
Vol 60 (7) ◽  
pp. 902-914 ◽  
Author(s):  
P. B. Jeppesen ◽  
R. Gilroy ◽  
M. Pertkiewicz ◽  
J. P. Allard ◽  
B. Messing ◽  
...  
Keyword(s):  
Parenteral Nutrition ◽  
Short Bowel Syndrome ◽  
Controlled Trial ◽  
Intravenous Fluid ◽  
Short Bowel

scholarly journals Managing Successful Pregnancies in Patients with Chronic Intestinal Failure on Home Parenteral Nutrition: Experience from a UK National Intestinal Failure Unit

2017 ◽  
Vol 26 (4) ◽  
pp. 375-379
Author(s):  
Ashley Bond ◽  
Dipesh H. Vasant ◽  
Wadiamu Gashau ◽  
Arun Abraham ◽  
Antje Teubner ◽  
...  
Keyword(s):  
Parenteral Nutrition ◽  
Short Bowel Syndrome ◽  
Intestinal Failure ◽  
Home Parenteral Nutrition ◽  
The Other ◽  
Short Bowel ◽  
Child Bearing ◽  
Spontaneous Labour ◽  
Daily Allowance ◽  
Related Line

Background & Aim: There are minimal reports of pregnancy in the chronic intestinal failure (CIF)/ home parenteral nutrition (HPN) population, with some concern relating to the risk associated with such pregnancies. The aim of this retrospective observational study was to evaluate pregnancy experience and outcomes in patients with CIF requiring HPN in a national UK CIF referral centre.Method: All known pregnancies in patients treated with HPN for CIF between 1982 and 2016 were identified retrospectively from a prospectively maintained database. Maternal and foetal outcomes were collated, along with PN requirements before and during pregnancy.Results: There were 5 pregnancies in 5 mothers in our cohort consisting of over 700 patients, males and females. The median age at conception was 28 years (range 24-33 years). The median duration on HPN prior to pregnancy was 26 months (range 4-85 months). One patient had Crohn’s disease, another had pan-enteric dysmotility and the other three patients had ischaemic complications leading to short bowel syndrome (SBS). All mothers were intensively monitored in an obstetric clinic and a dedicated CIF multi-disciplinary clinic throughout pregnancy. There were 2/5 preterm deliveries. One of the preterm deliveries was associated with spontaneous labour and the other had a planned induction as a result of maternal clinical need. Neonatal complications were seen in both prenates. There were no recorded maternal catheter related line infections during the 5 pregnancies.Conclusion: Successful pregnancy whilst receiving HPN is feasible but requires close, intensive monitoring and dedicated optimisation of PN in order to minimise maternal and foetal complications. All women of child-bearing age on HPN should be counselled about pregnancy.Abbreviations: ALP: alkaline phosphatase; ALT: alanine transaminase; CIF: chronic intestinal failure; HPN: home parenteral nutrition; IBD: inflammatory bowel disease; IF: intestinal failure; IFALD: Intestinal Failure associated liver disease; LFT: liver function test; PN: parenteral nutrition; RDA: Recommended daily allowance; SBS: short bowel syndrome; TPN: total parenteral nutrition.

scholarly journals P582 Insights on the sphingolipid profile in patients with short bowel syndrome and consecutive intestinal failure

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S536-S536
Author(s):  
A Kubesch ◽  
F Knauer ◽  
D Thomas ◽  
K Jakobi ◽  
N Filmann ◽  
...  
Keyword(s):  
Parenteral Nutrition ◽  
Short Bowel Syndrome ◽  
Intestinal Failure ◽  
Rare Condition ◽  
University Hospital ◽  
Short Bowel ◽  
Protein Levels ◽  
Sphingosine 1 Phosphate ◽  
Male Patients ◽  
The University

Abstract Background Short bowel syndrome (SBS) is a rare condition, and providing care for these patients can be challenging. Investigating the serologic sphingolipid profile has enhanced the understanding of various pathophysiologic conditions. However, data on the serologic sphingolipid profile in patients with SBS are –to date- not available. Methods Serum probes from patients with SBS treated in the outpatient clinic of the Department of Gastroenterology and Hepatology of the University Hospital Frankfurt were included and analyzed retrospectively. Serologic sphingolipid (SL) and especially ceramide (Cer) levels were assessed by LC-MS/MS and correlated with clinical and laboratory chemical parameters. Results A total of 37 (16 male) patients with SBS were included, 11 with Crohn’s disease (CD) (29.73%). Patients’ median age was 62 (24–88), with a median weight of 59 kilograms (42–75). Patients with less than 100 centimeters of small intestine had significantly higher creatinine and lower total protein levels, whereas the serologic SL-profile was not significantly affected. Furthermore, Sphingosine-1-Phosphate (S1P) and C18-Cer were increased in patients with SBS with CD as the underlying etiology. No significant differences in the sphingolipidomic profile were observed between patients on total parenteral nutrition than patients with oral and parenteral nutrition and patients with associated elevation of the liver enzymes. Conclusion Conclusion: Our study provides first insights into the serologic SL profile of patients with SBS. We showed that patients with CD present with an altered SL profile compared to other aetiologies, while the occurrence of liver disease in this single-center cohort does not appear to affect the serologic SL profile in respective patients.

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