Understanding short bowel syndrome: Current status and future perspectives

Massironi, Sara; Cavalcoli, Federica; Rausa, Emanuele; Invernizzi, Pietro; Braga, Marco; Vecchi, Maurizio

doi:10.1016/j.dld.2019.11.013

Cited by 92 publications

(140 citation statements)

References 87 publications

(105 reference statements)

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“…The clinical manifestations after resection are influenced by the functional capability of the remaining gastrointestinal tract to compensate and to familiarize with the reduced total length [ 10 ]. The remnant bowel compensates by a process of adaptation which is regarded as deepening and elongation of crypts and villi respectively.…”

Section: Discussionmentioning

confidence: 99%

“…This increases the ability for absorption and digestion per each unit of bowel length [ 11 ]. This phase usually lasts for one to two years [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…The duration of parenteral nutrition depends on the length and location of the resected bowels and the presence of the ileocecal valve. Switching to enteral feeding is essential and promotes adaptation [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Adult patient living 32 years with postduodenal remnant small bowel of only 35 cm in jejunocolic anastomosis type II weaned off parenteral nutrition. A case report

El-Helou

Alimoradi

Sabra

et al. 2020

International Journal of Surgery Case Reports

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Highlights The small intestine is an essential constituent of the digestive system and plays a major role in the absorption of nutrients. Acute mesenteric ischemia remains an emergency case. Failure to adapt and the inadequate nutritional supply result in Short bowel syndrome. A minimal indispensable length is required for nutritional autonomy. Parenteral Nutrition still presents a pertinent problem of complications, charges and impairment in quality of life.

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Section: Discussionmentioning

confidence: 99%

“…This increases the ability for absorption and digestion per each unit of bowel length [ 11 ]. This phase usually lasts for one to two years [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Adult patient living 32 years with postduodenal remnant small bowel of only 35 cm in jejunocolic anastomosis type II weaned off parenteral nutrition. A case report

El-Helou

Alimoradi

Sabra

et al. 2020

International Journal of Surgery Case Reports

View full text Add to dashboard Cite

show abstract

“…During this phase, usually lasting 1-2 years, the patients should eat by mouth. There is no specific diet for individuals with short bowel syndrome, but patients should eat at least five or more small meals/day and avoid concentrated sugars; furthermore, vitamin or mineral supplementation might be necessary [81]. Approximately 50% of prolonged acute intestinal failure evolves to chronic intestinal failure (CIF) [82], which requires home-based parenteral nutrition (HPN) and various drugs, including common anti-diarrheal medication (e.g., loperamide, codeine), PERT, bile acid resins such as cholestyramine, antibiotics for bacterial overgrowth, lactase supplement, and drugs that reduce the frequency and volume of total parenteral nutrition (e.g., teduglutide) [81].…”

Section: Diarrhea Secondary To Short Bowel Syndrome After Extensive Smentioning

confidence: 99%

Differential Diagnosis and Management of Diarrhea in Patients with Neuroendocrine Tumors

Pusceddu

Rossi

Torchio

et al. 2020

JCM

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Diarrhea is a recurrent symptom in patients with neuroendocrine tumors (NETs) and can represent different etiologies; thus, differential diagnosis is challenging. This paper distinguishes the different causes of chronic diarrhea in patients with gastroenteropancreatic NETs, with the aim to identify the most appropriate therapeutic approach. Underlying causes of diarrhea can be multifactorial, including not only diarrhea that is related to specific hormonal hypersecretory syndromes, but also diarrhea that is secondary to the following: extensive surgery which can cause pancreatic exocrine insufficiency or short bowel syndrome, treatment with somatostatin analogs or other antineoplastic agents, and bile acid malabsorption. After initial management of diarrhea with general treatments (dietary modification, use of antidiarrheals), a proper differential diagnosis is necessary to treat patients with specific etiology-driven therapeutic approaches, such as somatostatin analogs, pancreatic enzyme replacement therapy, and tryptophan hydroxylase inhibitors. In conclusion, NETs should be considered in the differential diagnosis of patients suffering from chronic diarrhea, after the exclusion of more common etiologies. Furthermore, physicians should keep in mind that several different etiologies might be responsible for diarrhea occurrence in NET patients. A prompt diagnosis of the actual cause of diarrhea is necessary to guide the treatment and a multidisciplinary approach is mandatory.

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“…Once patients are in the scanner, MRI also provides the opportunity to explore the use of other quantitative MRI methods for the evaluation of chronic liver disease. For example, liver PDFF measurements rely on T2* mapping data which can also be used to derive robust estimates of liver iron concentration [73,75], and may be of interest in assessing metabolic consequences of long-term parenteral nutrition [76]. Measurements of liver T1 have been correlated with fibrosis in chronic liver disease [77] and measurements of portal venous and hepatic arterial blood flow using phase-contrast MRI have been correlated with the severity of portal hypertension [78].…”

Section: Introductionmentioning

confidence: 99%

Serum Scoring and Quantitative Magnetic Resonance Imaging in Intestinal Failure-Associated Liver Disease: A Feasibility Study

et al. 2020

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(1) Background: Intestinal failure-associated liver disease (IFALD) in adults is characterized by steatosis with variable progression to fibrosis/cirrhosis. Reference standard liver biopsy is not feasible for all patients, but non-invasive serological and quantitative MRI markers for diagnosis/monitoring have not been previously validated. Here, we examine the potential of serum scores and feasibility of quantitative MRI used in non-IFALD liver diseases for the diagnosis of IFALD steatosis; (2) Methods: Clinical and biochemical parameters were used to calculate serum scores in patients on home parenteral nutrition (HPN) with/without IFALD steatosis. A sub-group underwent multiparameter quantitative MRI measurements of liver fat fraction, iron content, tissue T1, liver blood flow and small bowel motility; (3) Results: Compared to non-IFALD (n = 12), patients with IFALD steatosis (n = 8) demonstrated serum score elevations in Enhanced Liver Fibrosis (p = 0.032), Aspartate transaminase-to-Platelet Ratio Index (p < 0.001), Fibrosis-4 Index (p = 0.010), Forns Index (p = 0.001), Gamma-glutamyl transferase-to-Platelet Ratio Index (p = 0.002) and Fibrosis Index (p = 0.001). Quantitative MRI scanning was feasible in all 10 sub-group patients. Median liver fat fraction was higher in IFALD steatosis patients (10.9% vs 2.1%, p = 0.032); other parameter differences were non-significant; (4) Conclusion: Serum scores used for non-IFALD liver diseases may be useful in IFALD steatosis. Multiparameter MRI is feasible in patients on HPN.

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Understanding short bowel syndrome: Current status and future perspectives

Cited by 92 publications

References 87 publications

Adult patient living 32 years with postduodenal remnant small bowel of only 35 cm in jejunocolic anastomosis type II weaned off parenteral nutrition. A case report

Adult patient living 32 years with postduodenal remnant small bowel of only 35 cm in jejunocolic anastomosis type II weaned off parenteral nutrition. A case report

Differential Diagnosis and Management of Diarrhea in Patients with Neuroendocrine Tumors

Serum Scoring and Quantitative Magnetic Resonance Imaging in Intestinal Failure-Associated Liver Disease: A Feasibility Study

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