Emerging treatments for short bowel syndrome in adult patients

Expert Review of Gastroenterology & Hepatology
Lore Billiauws, Francisca Joly

Abstract

Short bowel syndrome (SBS) is the major cause of chronic intestinal failure (IF), defined as 'the reduction of gut function below the minimum necessary for the absorption of macronutrients and/or water and electrolytes, such that intravenous supplementation is required to maintain health and/or growth'. Areas covered: Spontaneous intestinal adaptation, including increased hormonal secretion, development of hyperphagia and gut microbiota dysbiosis, occurs 2 years after resection, improving intestinal absorption and decreasing PN dependency. Hormonal treatments, promoting intestinal hyperadaptation, have been proposed in patients with SBS with chronic IF. Clinical studies showed teduglutide to increase urine production and reduce the need for parenteral support volume in these patients. According to the latest ESPEN Guidelines, if a growth factor treatment is considered, the GPL2 analog, teduglutide, should be the first-choice treatment. Expert opinion: These therapies underline the importance of patient monitoring at home and the complexity for HPN adaptation. A multidisciplinary approach should be a gold standard.

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Citations

Feb 20, 2020·Current Opinion in Organ Transplantation·Mathias ClarysseJacques Pirenne
Feb 15, 2020·Expert Opinion on Pharmacotherapy·Mariana Hollanda Martins Da RochaJoel Faintuch
Jul 10, 2021·World Journal of Gastroenterology : WJG·Aysegül AksanJürgen Stein

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