TY - JOUR
T1 - Short bowel syndrome and intestinal failure in Crohn's disease
AU - Limketkai, Berkeley N.
AU - Parian, Alyssa M.
AU - Shah, Neha D.
AU - Colombel, Jean Frédéric
N1 - Publisher Copyright:
© 2016 Crohn's & Colitis Foundation of America, Inc.
PY - 2016/5/1
Y1 - 2016/5/1
N2 - Crohn's disease is a chronic and progressive inflammatory disorder of the gastrointestinal tract. Despite the availability of powerful immunosuppressants, many patients with Crohn's disease still require one or more intestinal resections throughout the course of their disease. Multiple resections and a progressive reduction in bowel length can lead to the development of short bowel syndrome, a form of intestinal failure that compromises fluid, electrolyte, and nutrient absorption. The pathophysiology of short bowel syndrome involves a reduction in intestinal surface area, alteration in the enteric hormonal feedback, dysmotility, and related comorbidities. Most patients will initially require parenteral nutrition as a primary or supplemental source of nutrition, although several patients may eventually wean off nutrition support depending on the residual gut anatomy and adherence to medical and nutritional interventions. Available surgical treatments focus on reducing motility, lengthening the native small bowel, or small bowel transplantation. Care of these complex patients with short bowel syndrome requires a multidisciplinary approach of physicians, dietitians, and nurses to provide optimal intestinal rehabilitation, nutritional support, and improvement in quality of life.
AB - Crohn's disease is a chronic and progressive inflammatory disorder of the gastrointestinal tract. Despite the availability of powerful immunosuppressants, many patients with Crohn's disease still require one or more intestinal resections throughout the course of their disease. Multiple resections and a progressive reduction in bowel length can lead to the development of short bowel syndrome, a form of intestinal failure that compromises fluid, electrolyte, and nutrient absorption. The pathophysiology of short bowel syndrome involves a reduction in intestinal surface area, alteration in the enteric hormonal feedback, dysmotility, and related comorbidities. Most patients will initially require parenteral nutrition as a primary or supplemental source of nutrition, although several patients may eventually wean off nutrition support depending on the residual gut anatomy and adherence to medical and nutritional interventions. Available surgical treatments focus on reducing motility, lengthening the native small bowel, or small bowel transplantation. Care of these complex patients with short bowel syndrome requires a multidisciplinary approach of physicians, dietitians, and nurses to provide optimal intestinal rehabilitation, nutritional support, and improvement in quality of life.
KW - Crohn's Disease
KW - enteral nutrition
KW - intestinal failure
KW - nutrition support
KW - parenteral nutrition
KW - short bowel syndrome
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U2 - 10.1097/MIB.0000000000000698
DO - 10.1097/MIB.0000000000000698
M3 - Review article
C2 - 26818425
AN - SCOPUS:84964889404
SN - 1078-0998
VL - 22
SP - 1209
EP - 1218
JO - Inflammatory bowel diseases
JF - Inflammatory bowel diseases
IS - 5
ER -