Low-dose growth hormone in adult home parenteral nutrition–dependent short bowel syndrome patients: A positive study

Nutrient intake from habitual oral diet in patients with severe short bowel syndrome living in the southeastern United States

“…The net intestinal macronutrient absorption values in our subjects are within the range of those reported in other studies of PN-dependent SBS patients (12)(13)(14)(15)(16). This broad range of nutrient absorption is related to the remaining small bowel length but also to the underlying disease and the anatomy of remnant intestine.…”

“…These and other as yet unrecognized effects of luminal food may enhance adaptive growth of residual bowel mucosa and ultimately decrease the need for PN in human SBS. Unfortunately, little data are available on the effects of diet on adaptive intestinal mucosal growth in human SBS (10,13,16,20,21). With regard to the effects of PN, one study showed that use of PN without enteral food in healthy adults induced small bowel mucosal atrophy that was reversed by enteral tube feeding (19).…”

New growth factor therapies aimed at improving intestinal adaptation in short bowel syndrome

“…Positive outcomes following GH treatment have been demonstrated when rhGH was administered within 3-6 months of extensive small bowel resection, 122 and also when administered 1-12 years after resection. 55,68 However, to date no one study has investigated the effect of different doses of rhGH. In studies of rGLP-2 therapy patients received only 5 weeks therapy.…”

“…58 Contrary to this, Seguy et al report that low-dose GH treatment for 3 weeks in PN-dependent adults on an unrestricted, hyperphagic diet, resulted in significant increases in intestinal absorption and resultant increases in bodyweight and lean body mass. 55 The variability in reported outcomes to rhGH supplementation in patients with SBS may be due to differences in study methodology, diet and other supplements provided and the small sample size studied. It has been suggested that only an ongoing, large, double-blind, multicenter, randomized, placebo-controlled trial looking at the efficacy of rhGH is likely to resolve the controversy surrounding GH therapy.…”

“…In rat resection models, recombinant GH (rGH)-induced adaptation of the small intestinal remnant is closely related to systemic 53,54 and local intestinal IGF-1 production, 53 and clinical trials of GH treatment have reported significantly increased levels of IGF-1 and IGF-binding protein-3. 5,[55][56][57][58] However, application of recombinant IGF-1 treatment for SBS has not been reported, and Loss of inhibition on gastric emptying and intestinal transit. 22 Site of resection Maximal resection-induced adaptation requires presence of the ileum 20 Length of remaining bowel To prevent dependence on TPN, this is approx.…”