Chronic Intestinal Failure: Portuguese Overview and Future Perspectives.

Abstract

Background: Chronic intestinal failure (CIF) is a rare and complex condition in which patients require long-term intravenous supplementation to maintain health and quality of life. Across Europe, initiatives led by the European Society of Clinical Nutrition and Metabolism (ESPEN) and the European Nutrition Health Alliance have sought to harmonize definitions, care standards, and access to home parenteral support. However, international differences remain significant, particularly in countries where CIF care structures are still developing.

Summary: This review outlines the current landscape of CIF care in Portugal, from its formal recognition to the ongoing establishment of national standards. This review revisits the traditional difficulties of CIF patients' management, the changes that come along with the publication of Health Directive 017/2020 marking a turning point, providing a legal and organizational framework for home management and multidisciplinary nutrition support teams. Recent Portuguese and European studies highlight both the progress achieved and the continuing gaps in coordination, registry data, and specialized services. Integrating the new ESPEN quality-of-care standards into clinical practice represents an opportunity to consolidate a structured national network, promote equity of access, and align Portuguese practice with broader European benchmarks.

Key messages: CIF remains underrecognized and underreported in Portugal, highlighting the need for developing the current national registry and dedicated referral network. Legislative advances and professional initiatives represent critical first steps toward equitable, evidence-based CIF management and integration into European care models. Implementation of structured multidisciplinary teams and adherence to ESPEN quality-of-care standards are pivotal to improving safety, outcomes, and cost efficiency. Portuguese progress has been clear and significant, but there is still a long way to travel before reaching European standards of CIF patient care.