Short bowel syndrome and intestinal failure in Crohn's disease

Berkeley N. Limketkai, Alyssa Parian, Neha D. Shah, Jean Frédéric Colombel

Research output: Contribution to journalReview article

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1209-1218
Number of pages10
JournalInflammatory Bowel Diseases
Volume22
Issue number5
DOIs
StatePublished - May 1 2016

Keywords

  • Crohn's Disease
  • enteral nutrition
  • intestinal failure
  • nutrition support
  • parenteral nutrition
  • short bowel syndrome

ASJC Scopus subject areas

  • Gastroenterology
  • Immunology and Allergy

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