Intestinal failure

Refers to loss of nutritional autonomy due to gut dysfunction.

Management is initially parenteral nutrition.

Many with short bowel syndrome require only temporary parenteral support to allow the intestine to adapt and feedings can be discontinued.

Process is variable and unpredictable with rapid adaptation in some and in others it is a slow process or never resolved.

Plasma citrulline is a marker of intestinal epithelial biomass and may predict the likelihood of bowel nutrition rehabilitation.

If the process is irreversible intestinal transplantation is a consideration.

Teduglutide a glucagon-like peptide 2 analogue promotes growth of intestinal mucosa, restores intestinal structural functional integrity, reduces gastric emptying and secretion and reduces volumes and parenteral nutritional support in patients with short bowel syndrome with intestinal failure (Jeppesen P et al ).

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