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Related Concept Videos

Chronic Bowel Disorders: Introduction01:17

Chronic Bowel Disorders: Introduction

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Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
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Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
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The pancreas, an elongated and flat gland situated behind the stomach, serves a vital function in digesting food and managing blood sugar levels.
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Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
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Chronic Intestinal Failure in Children: An International Multicenter Cross-Sectional Survey.

Antonella Lezo1, Antonella Diamanti2, Evelyne M Marinier3

  • 1Department of Clinical Nutrition, OIRM-S, Anna Hospital, Città della Salute e della Scienza, 10126 Turin, Italy.

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Chronic intestinal failure (CIF) in children is often linked to short bowel syndrome (SBS) in younger patients and dysmotility or mucosal disease in older ones. Intravenous supplementation (IVS) dependency may indicate disease severity.

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Area of Science:

  • Pediatric Gastroenterology
  • Clinical Nutrition
  • Parenteral Nutrition

Background:

  • Analysis of the European Society for Clinical Nutrition and Metabolism database for chronic intestinal failure (CIF).
  • Focus on factors influencing nutritional status and intravenous supplementation (IVS) dependency in pediatric patients.

Purpose of the Study:

  • To investigate the relationship between CIF mechanisms, nutritional status, and IVS dependency in children.
  • To identify potential markers for CIF severity.

Main Methods:

  • Retrospective analysis of 558 patients from the CIF database.
  • Collected data included demographics, CIF etiology, home parenteral nutrition details, and anthropometric z-scores (WFA, LFA/HFA, BMI-FA).
  • IVS dependency quantified as %IVSE/REE; multivariate analysis performed.

Main Results:

  • Short bowel syndrome (SBS) was the primary CIF mechanism in younger children (1-4 years), while intestinal dysmotility or mucosal disease predominated in adolescents (14-18 years).
  • One-third of patients exhibited underweight/stunted growth (z-scores < -2) and high IVS dependency (>125% IVSE/REE).
  • CIF mechanism correlated with nutritional status and IVS dependency; mucosal disease negatively impacted z-scores, while dysmotility increased %IVSE/REE.

Conclusions:

  • Age-related shifts in CIF mechanisms are evident, from SBS in early childhood to dysmotility/mucosal disease in adolescence.
  • Significant proportions of pediatric CIF patients suffer from malnutrition and high reliance on IVS.
  • IVS dependency emerges as a significant indicator, potentially reflecting overall CIF severity in children.