Chronic intestinal failure and short bowel syndrome in Crohn’s disease

Aksan, A; Farrag, Karima; Blumenstein, Irina; Schröder, Oliver; Dignaß, Axel; Stein, Jürgen M.

doi:10.3748/wjg.v27.i24.3440

Cited by 25 publications

(32 citation statements)

References 162 publications

(192 reference statements)

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“…Primary BAs are essential nutrients for the growth of C. difficile and can lead to the proliferation of C. difficile . A significant increase in the level of primary BAs at the beginning of weaning has the effect of promoting C. difficile , so it increases the incidence of diarrhea in piglets at the beginning of weaning, which is consistent with Xia Bing’s study [ 32 ]. Xia Bing found that the incidence of diarrhea in the weaning group was 4.63% compared to 0.93% in the lactating group [ 33 , 34 ].…”

Section: Discussionsupporting

confidence: 87%

Effect of Weaning at 21 Days of Age on the Content of Bile Acids in Chyme of Cecum

Xie

Wang

et al. 2022

Animals

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This experiment was conducted to investigate the effects of weaning at 21 days of age on cecal chyme bile acids (BAs) in piglets. According to a 2 × 3 factorial design, the main factors were lactation and weaning, and the other factor was 22, 24, and 28 days of age, respectively. Piglets were randomly divided into two groups of eighteen piglets each and six piglets were selected for slaughter at 22, 24, and 28 days of age, respectively, to determine the content of different types of Bas in the intestinal lumen of the cecum. Results: (1) There was a significant interaction between weaning and age on intestinal primary Bas hyocholic acid (HCA) and chenodeoxycholic acid (CDCA) (p < 0.05), and weaning significantly increased the content of primary BAs in piglets’ intestines, which showed a trend of decreasing and then increasing with the increase in piglets’ age. (2) There was a significant interaction between weaning and age on intestinal secondary BAs deoxycholic acid (DCA), lithocholic acid (LCA), and ursodeoxycholic acid (UDCA) (p < 0.05). DCA and LCA in piglets’ intestines tended to decrease with increasing age, while UDCA showed a trend of decreasing and then increasing with increasing piglets’ age; weaning significantly increased the content of secondary BAs in piglets’ intestines. (3) There was a significant interaction between weaning and age on intestinal glycine chenodeoxycholic acid (GCDCA), taurochenodeoxycholic acid (TCDCA), and taurolithocholic acid (TLCA), but not on taurohyocholic acid (THCA), taurohyodeoxycholic acid (THDCA), and taurineursodeoxycholic acid (TUDCA) (p > 0.05). Weaning significantly increased the contents of GCDCA, TCDCA, TLCA, THDCA, and TUDCA in the intestinal tract (p < 0.05), while THCA content was not significant. In conclusion, weaning can increase the BAs content in the cecum of piglets, and there is an interaction between group and weaning age on BAs content.

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Section: Discussionsupporting

confidence: 87%

Effect of Weaning at 21 Days of Age on the Content of Bile Acids in Chyme of Cecum

Xie

Wang

et al. 2022

Animals

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“…However, while optimizing nutritional status may be an effective countermeasure against sarcopenia in IBD, there is currently no established evidence on the role of specific diets or supplements for the prevention and treatment of sarcopenia in IBD. On the other hand, recent advances in nutritional therapy for postoperative short bowel syndrome for Crohn’s disease can inhibit the exacerbation of sarcopenia [ 100 ].…”

Section: Intervention For Patients With Ibd and Sarcopeniamentioning

confidence: 99%

Inflammatory Bowel Disease and Sarcopenia: Its Mechanism and Clinical Importance

Nishikawa

Nakamura

Miyazaki

et al. 2021

JCM

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Malnutrition is a major contributor to muscle loss and muscle dysfunction, known as sarcopenia. Malnutrition is common in patients with inflammatory bowel disease (IBD). IBD includes ulcerative colitis (UC) and Crohn’s disease (CD). The number of patients with IBD has recently been increasing. More severe malnutrition is often seen in CD compared to UC, probably due to CD affecting the main site of nutrient absorption, extensive mucosal lesions, fistulas, short bowel syndrome after resection, or obstruction of the gastrointestinal tract. A recent meta-analysis showed the high prevalence of sarcopenia in patients with IBD, and thus sarcopenia is a very important problem for IBD. Although IBD is more common in younger patients, sarcopenia can develop through a variety of mechanisms, including malnutrition, chronic inflammation, increased inflammatory status in adipose tissue, vitamin deficiency, and imbalance of the muscle–gut axis. In addition, sarcopenia has a negative impact on postoperative complications and hospital stay in patients with IBD. Appropriate intervention for sarcopenia may be important, in addition to clinical remission and endoscopic mucosal healing in patients with IBD. Much more attention will thus be paid to sarcopenia in patients with IBD. In this review, we outline IBD and sarcopenia, based on the current evidence.

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“…The ESPEN guidelines for IBD particularly recommend that CD patients with a proximal fistula and/or a very high output fistula should receive nutritional support by partial or total PN. Since trials show no benefit of PN in the management of acute severe UC, both in terms of inflammatory disease and precolectomy optimization, it is only recommended in malnourished patients with UC and severe disease when EN cannot to be tolerated or oral nutrition or EN are not effective [ 160 , 163 , 164 , 165 ]. As previously mentioned, EN is recommended over PN for use in preoperative optimization [ 5 , 163 , 166 ].…”

Section: Disease-specific Pnmentioning

confidence: 99%

Parenteral Nutrition Overview

Berlana

2022

Nutrients

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Parenteral nutrition (PN) is a life-saving intervention for patients where oral or enteral nutrition (EN) cannot be achieved or is not acceptable. The essential components of PN are carbohydrates, lipids, amino acids, vitamins, trace elements, electrolytes and water. PN should be provided via a central line because of its hypertonicity. However, peripheral PN (with lower nutrient content and larger volume) can be administered via an appropriate non-central line. There are alternatives for the compounding process also, including hospital pharmacy compounded bags and commercial multichamber bags. PN is a costly therapy and has been associated with complications. Metabolic complications related to macro and micronutrient disturbances, such as hyperglycemia, hypertriglyceridemia, and electrolyte imbalance, may occur at any time during PN therapy, as well as infectious complications, mostly related to venous access. Long-term complications, such as hepatobiliary and bone disease are associated with longer PN therapy and home-PN. To prevent and mitigate potential complications, the optimal monitoring and early management of imbalances is required. PN should be prescribed for malnourished patients or high-risk patients with malnutrition where the feasibility of full EN is in question. Several factors should be considered when providing PN, including timing of initiation, clinical status, and risk of complications.

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Chronic intestinal failure and short bowel syndrome in Crohn’s disease

Cited by 25 publications

References 162 publications

Effect of Weaning at 21 Days of Age on the Content of Bile Acids in Chyme of Cecum

Effect of Weaning at 21 Days of Age on the Content of Bile Acids in Chyme of Cecum

Inflammatory Bowel Disease and Sarcopenia: Its Mechanism and Clinical Importance

Parenteral Nutrition Overview

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