Intestinal failure and short bowel syndrome

Abstract

Intestinal failure is a rare condition characterized by the inability of the gut to absorb sufficient nutrients and/or fluids and electrolytes to maintain health. These patients require parenteral (intravenous) supplementation. Short bowel syndrome is the most common cause and is typically secondary to extensive surgical resection. Intestinal failure requires management by a multidisciplinary team to provide nutritional support and facilitate intestinal rehabilitation. This involves surgery to restore intestinal continuity where possible, dietary modifications and medical therapies to modify motility and secretions, and increase intestinal absorptive capacity. Individuals requiring parenteral support are monitored for complications of chronic intestinal failure and home parenteral nutrition such as catheter infections and thrombosis, and liver and metabolic bone disease; rarely, they require referral for intestinal transplantation. Quality of life is an important consideration as patients could be on home parenteral support for extended periods, in some cases life-long.