Short bowel syndrome and Crohn's disease

Thompson, Jon S.; Iyer, Kishore; DiBaise, John K.; Young, Renée; Brown, C.; Langnas, Alan Norman

doi:10.1016/s0016-5085(03)84039-8

Cited by 9 publications

(16 citation statements)

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“…Finally, extensive SB resection may be the direct consequence of surgical complications related to overzealous surgical procedures. In the study of Thompson et al, 24 including 30 CD patients with CIF, two main factors leading to CIF were identified: an initial diagnostic error and the occurrence of surgical complications requiring additional resections. In a cohort of 34 patients with CD receiving HPN, Agwunobi et al, identified two other factors.…”

Section: Discussionmentioning

confidence: 99%

“…These two articles referred to patients treated a few decades ago before the major use of immunosuppressive therapy. 24,25 The aim of our study was to report on a French cohort of CD patients with CIF receiving HPN and to identify the factors associated with the occurrence of severe CIF. 27 All CDrelated surgical procedures were registered, except for isolated stoma procedure or enterostomy closure without intestinal resection.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Crohn’s disease patients with chronic intestinal failure receiving long-term parenteral nutrition: a cross-national adult study

Elriz

Palascak-Juif

Joly

et al. 2011

Alimentary Pharmacology &Amp; Therapeutics

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Crohn’s disease patients with chronic intestinal failure receiving long-term parenteral nutrition: a cross-national adult study

Elriz

Palascak-Juif

Joly

et al. 2011

Alimentary Pharmacology &Amp; Therapeutics

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“…A study of 30 CD patients with SBS included 10 with a small intestinal remnant length of less than 60 cm, 6 with a length of 60-120 cm, and 14 with a length greater than 120 cm [12] . It is important to measure the length of the remaining small bowel during surgical resections in CD patients to adapt further medical strategy of those at high risk of SBS onset.…”

Section: Intestinal Failurementioning

confidence: 99%

“…Not all the factors associated with the development of Type 3 IF in CD patients have been identified, but severity of the underlying disease (e.g., penetrating complications, abscesses, fistulas, or peritonitis) and an initial short SB length could be involved [9] . Surgical complications requiring extensive additional resections, initial diagnostic errors, and insufficient and late prescription of immunosuppression therapy may also contribute to IF development [9,12] . Not much data are available on the longterm incidence of IF in CD patients, but a study from Japan [14] reported that the cumulative risk of IF after initial surgery was 0.8% at 5 years, 3.6% at 10 years, 6.1% at 15 years, and 8.5% at 20 years.…”

Section: Intestinal Failurementioning

confidence: 99%

Crohn's Disease and Intestinal Transplantation

Drastich

Oliverius

2017

Dig Dis

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Background: Most patients with Crohn's disease (CD) require one or more operations during their lifetime. Repeated resections and surgical complications may result in short gut in a subset of patients, typically those with extensive small bowel disease or a penetrating CD phenotype. The effects of short bowel syndrome (SBS) can range in seriousness from mild to life-threatening advanced intestinal failure. Worldwide, CD is the second leading indication for intestinal transplantation (ITx) in SBS, but the overall incidence of ITx is quite low. Key Messages: Currently, total parenteral nutrition (TPN) is the preferred treatment option for patients with SBS because of its superior survival outcome. However, TPN can fail from loss of venous access due to catheter-associated thromboses, recurrent catheter-related blood stream infections, or intestinal-failure-associated liver dysfunction. Three types of transplantations are available for CD patients - small bowel alone, liver plus small bowel and multivisceral, which includes other intra-abdominal organs. An abdominal wall transplant is required in case of abdominal wall defects or lack of free intra-abdominal space. The current 5-year survival rate of 54% following ITx of the isolated small bowel appears worse than that associated with TPN. However, outcomes are substantially improving because of surgical and technical advances and progress in medical therapy. On the other hand, ITx carries the risk of both complications (e.g., rejection, infections, and post transplant lymphoproliferative disorders) and adverse events associated with immunosuppression. CD recurrence has been reported in a few patients, but this primarily histologic recurrence might not be of great clinical importance. Conclusions: ITx has become a well-established treatment for those who fail on TPN and who have life-threatening complications. Fortunately, it concerns only a small proportion of CD patients, but it does offer reasonable survival and quality of life. Primary management of patients with small bowel failure should be provided by a center experienced in medical intestinal rehabilitation, nutrition, and transplantation of other solid organs.

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Kidney stones are common in patients with short‐bowel syndrome receiving long‐term parenteral nutrition: A predictive model for urolithiasis

Rudziński¹,

Ławiński

Gradowski

et al. 2021

J Parenter Enteral Nutr

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Background:In short-bowel syndrome (SBS) treated with parenteral nutrition (PN), multiple complications can occur. The etiology of kidney stones may be linked to the underlying disease thrombosis, surgical complications, complications of therapy for cancer, Crohn's disease, metabolic abnormalities resulting from morphological and functional changes in the gastrointestinal tract, and to treatment used. We analyzed all these parameters in a large cohort of patients receiving home PN (HPN), to define the incidence of stones and groups of patients particularly at risk of stone formation. One of the objectiveswas to develop a predictive model of urolithiasis. Methods: This observational retrospective study included 459 patients with SBS recieving HPN in a single center. Patient records were evaluated for demographics, SBS etiology, and underlying disease, anatomy of the gastrointestinal tract, intestinal failure classification, nutrition regimen, and presence of urolithiasis.Results: Kidney stones were diagnosed in 24% of patients. Nodifferences in incidence were noted between the various etiologic groups. The incidence in patients with a colon in continuity and those with an end stoma was similar. The length of residual small bowel did not play a role in stone formation. There were no differences between patients according to the severity of intestinal failure. In patients treated with PN and limited oral feeding, the risk of urolithiasis was twice as high as in patients receiving PN only.Conclusions: Patients developed urolithiasis with no relation to the SBS etiology. The risk of kidney stone formation was higher in patients recieving PN with oral feeding.

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Short bowel syndrome and Crohn's disease

Cited by 9 publications

References 0 publications

Crohn’s disease patients with chronic intestinal failure receiving long-term parenteral nutrition: a cross-national adult study

Crohn’s disease patients with chronic intestinal failure receiving long-term parenteral nutrition: a cross-national adult study

Crohn's Disease and Intestinal Transplantation

Kidney stones are common in patients with short‐bowel syndrome receiving long‐term parenteral nutrition: A predictive model for urolithiasis

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