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Short Bowel Syndrome: Pharmacological Improvement of Bowel Function and Adaptation

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Current Concepts of Intestinal Failure

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Abstract

By presenting the pathophysiological changes in intestinal absorption following intestinal resection, the basis for pharmacological improvement of bowel function and adaptation is provided. In this chapter, the patient and treatment effect heterogeneity regarding conventional pharmacological and newer mediators of intestinal adaptation in short bowel syndrome (SBS) patients is presented. The more frequent use of metabolic balance studies to document treatment effects is advocated in the clinical setting in order to ensure the long-term clinical efficacy in the individual patients. Centres prescribing the newer hormonal mediators of intestinal adaptation should have the ability and the facilities to objectively evaluate and balance the benefit and clinical meaningfulness of the interventions versus the inconveniences, adverse effects, potential risks and cost.

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Abbreviations

Abd. Dist:

Abdominal distension

Abd. Pain:

Abdominal pain

BID:

Twice daily

CD:

Crohn’s Disease

EJIS:

End jejunostomy or ileostomy

GH:

Growth hormone

GI:

Gastrointestinal

GLP:

Glucagon-like peptide

Hab:

Habitual

HCLF:

High carbohydrate low fat

HPN:

Home parenteral nutrition

IF:

Intestinal failure

INS:

Intestinal insufficiency

IRA:

Ileorectal anastomosis

ITA:

Ileotransverse anastomosis

JRA:

Jejuno-rectal anastomosis

Mth:

Month

NM:

Not measured

NR:

Not reported

NS:

Non-significant

OD:

Once daily

OLCS:

Open-label case series

ORS:

Oral rehydration solutions

PPI:

Proton-pump inhibitor

PS:

Parenteral support

RCT:

Randomised controlled trial

SB:

Small bowel

SBS:

Short bowel syndrome

TID:

Three times daily

Unk:

Unknown

y:

Years

Δ:

Compared to baseline

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Authors and Affiliations

  1. Department of Gastroenterology, Rigshospitalet, Copenhagen, Denmark

    Palle Bekker Jeppesen

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  1. Palle Bekker Jeppesen
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  1. Children's Hospital, Helsinki University Central Hospital, HUS Helsinki, Finland

    Risto J. Rintala

  2. Children's Hospital, Helsinki University Central Hospital, HUS Helsinki, Finland

    Mikko Pakarinen

  3. Department of Pediatric Surgery, Karolinska University Hospital, Stockholm, Sweden

    Tomas Wester

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Jeppesen, P.B. (2016). Short Bowel Syndrome: Pharmacological Improvement of Bowel Function and Adaptation. In: Rintala, R., Pakarinen, M., Wester, T. (eds) Current Concepts of Intestinal Failure. Springer, Cham. https://doi.org/10.1007/978-3-319-42551-1_6

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