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Current Insights Regarding Intestinal Failure-Associated Liver Disease (IFALD): A Narrative Review

Marija Zafirovska1,2, Aleksandar Zafirovski1,3,4, Nada Rotovnik Kozjek1,5

  • 1Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia.

Nutrients
|July 29, 2023
PubMed

Insights

Intestinal failure-associated liver disease (IFALD) affects patients with intestinal failure (IF). This review covers IFALD causes, prevention, diagnosis, and treatment for better patient outcomes.

Area of Science:

  • Hepatology
  • Gastroenterology
  • Pediatric and Adult Medicine

Background:

  • Intestinal failure-associated liver disease (IFALD) encompasses a range of liver conditions, including cholestasis, biliary cirrhosis, steatohepatitis, and gallbladder disease.
  • Prevalence varies significantly, affecting up to 85% of neonates, 40-60% of pediatric patients, and 15-40% of adults with intestinal failure (IF).
  • IFALD arises from complex, multifactorial causes, including parenteral nutrition and patient-specific risk factors.

Purpose of the Study:

  • To review current knowledge on the etiology and pathophysiology of IFALD.
  • To examine the latest evidence on preventative measures, diagnostic approaches, and treatment strategies for IFALD.
  • To provide a comprehensive overview for managing IFALD and its complications.

Main Methods:

  • Literature review of existing studies on IFALD.
  • Synthesis of current data on risk factors and disease mechanisms.
  • Analysis of recent advancements in IFALD management.

Main Results:

  • IFALD presents a spectrum of liver conditions in patients with IF.
  • Etiology is multifactorial, involving both parenteral nutrition and patient-related factors.
  • Management requires a multidisciplinary, individualized approach based on the specific cause.

Conclusions:

  • IFALD is a significant complication of intestinal failure with diverse clinical presentations.
  • Understanding the multifactorial etiology is crucial for effective management.
  • A tailored, multidisciplinary strategy is essential for preventing and treating IFALD and its complications.

Keywords:
intestinal failureintestinal failure associated liver diseaseparenteral nutrition

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