Current Status of Chronic Intestinal Failure Management in Adults

Area of Science:

• Gastroenterology
• Surgical Sciences
• Pediatric Medicine

Background:

• Chronic intestinal failure (CIF) is a complex, heterogeneous condition impacting pediatric and adult populations globally.
• Management requires a multidisciplinary approach, with recent advances in nutritional support, surgery, pharmacology, and transplantation.
• International societies have issued guidelines for CIF patient management based on these advancements.

Purpose of the Study:

• To compare current international recommendations for CIF management with published real-world clinical experiences.
• To identify discrepancies between ideal treatment guidelines and practical application in various global programs.

Main Methods:

• A comprehensive literature review was conducted using PubMed.
• Search terms included: intestinal failure, CIF, home parenteral nutrition, short bowel syndrome, chronic intestinal pseudo-obstruction, intestinal transplant, enterohormones, and glucagon-like peptide-2.
• The review covered publications from 1980 to 2024.

Main Results:

• A significant gap exists between established guidelines/consensus and actual clinical practice worldwide.
• Many nations are unable to provide the full spectrum of treatments required for chronic intestinal failure.
• Disparities in care access are evident across different countries and healthcare systems.

Conclusions:

• Real-world application of chronic intestinal failure management deviates from recommended guidelines.
• Global disparities in treatment availability highlight the need for improved access, particularly in low-income countries.
• Developing international cooperative networks is crucial for ensuring comprehensive CIF treatment access for all patients.