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Related Experiment Videos

Management of intestinal failure.

K Soondrum1, R Hinds

  • 1Department of Child Health, King's College Hospital, London, United Kingdom.

Indian Journal of Pediatrics
|November 9, 2006
PubMed
Summary
This summary is machine-generated.

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Intestinal failure (IF) management focuses on achieving enteral autonomy to wean patients from costly parenteral nutrition (PN). Early enteral feeding and potential therapies aid intestinal adaptation, improving outcomes for short bowel syndrome (SBS).

Area of Science:

  • Gastroenterology
  • Pediatric Surgery
  • Nutritional Support

Background:

  • Intestinal failure (IF) results from loss of functional small bowel, often leading to short bowel syndrome (SBS).
  • Parenteral nutrition (PN) is the primary treatment for IF but carries risks like liver disease (PNALD) and sepsis.
  • Achieving enteral autonomy is crucial to discontinue PN and mitigate its complications.

Purpose of the Study:

  • To review current strategies for managing intestinal failure and promoting intestinal adaptation.
  • To discuss the role of enteral nutrition, pharmacological agents, and surgical interventions in achieving enteral autonomy.
  • To highlight the need for more pediatric data on therapies aimed at enhancing intestinal adaptation.

Main Methods:

  • Review of literature on intestinal failure, short bowel syndrome, and intestinal adaptation.

Related Experiment Videos

  • Discussion of management strategies including parenteral nutrition, enteral feeding, and pharmacological adjuncts.
  • Exploration of surgical options such as bowel lengthening and transplantation.

    • Main Results:

    • Enteral feeds are a key stimulant for intestinal adaptation, increasing absorptive capacity.
    • Pharmacological agents like glutamine, growth hormone, and GLP-2 may aid adaptation, but pediatric data is limited.
    • Surgical interventions and, in severe cases, small bowel transplantation are options when other methods fail.

    Conclusions:

    • Early initiation of enteral feeds is vital for promoting intestinal adaptation and achieving independence from PN.
    • Further research is needed, particularly in pediatrics, to optimize the use of adjunct therapies for IF.
    • Small bowel transplantation remains a critical option for IF patients with irreversible complications or PN intolerance.