Treating short bowel syndrome with pharmacotherapy.

Treating short bowel syndrome with pharmacotherapy. Expert Opin Pharmacother. 2020 Feb 14;:1-12 Authors: Hollanda Martins Da Rocha M, Lee ADW, Marin MLM, Faintuch S, Mishaly A, Faintuch J Abstract Introduction: Short bowel syndrome (SBS) has traditionally been regarded as a rapidly fatal medical catastrophe. The advent of pharmacological options directly targeting disease pathophysiology justified this review.Areas covered: Since the 1970s, home parenteral nutrition has reduced mortality, converting SBS into a chronic and disabling compensated and occasionally curable illness. Off-label antidiarrheal drugs and related products, though having minimal scientific evidence of efficacy, represent the standard-of-care and are here reviewed. Trophic intestinal hormones, including GLP-2 and its analogs, have great promise for alleviating malabsorption, the most important symptom within a nonsurgical, routine outpatient framework. Current indications involve adults with massive intestinal losses (fecal wet weight>1500 g/day). Surgical options such as intestinal lengthening or transplantation are also addressed although these options are considerably more aggressive and have stricter indications.Expert opinion: GLP-2 analogs are the first candidates from a pioneering pharmacotherapic family within the SBS framework, namely disease-modifying, absorption-restoring agents. This family of drugs, potentially applicable in all contexts of severe intestinal loss, could...
Source: Expert Opinion on Pharmacotherapy - Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Related Links:

Purpose of review To summarize changes and recent advances in therapies for chronic intestinal failure (CIF). Recent findings In the last few years, the management of CIF has significantly improved through better prevention and treatment of catheter-related bloodstream infections (CRBSIs) and intestinal failure-associated liver disease (IFALD), as well as improved enteral autonomy by using small bowel growth factors in selected patients. This may have been reflected by a recent reduction in small bowel transplantations. Summary Although CIF management has become more established and effective, the long-term implica...
Source: Current Opinion in Gastroenterology - Category: Gastroenterology Tags: SMALL INTESTINE: Edited by Reena Sidhu Source Type: research
Conclusions: In newborns with suspected GALD, a limited diagnostic work-up followed by early ET may lead to favorable outcomes. More data are required to develop an evidence-based clinical approach to GALD.
Source: Journal of Pediatric Gastroenterology and Nutrition - Category: Gastroenterology Tags: Original Articles: Hepatology Source Type: research
Purpose of review Intestinal transplantation (ITx) activity remains low in East Asia. We conducted a multinational, retrospective study on patients who underwent ITx in Korea, Taiwan, and Japan, to provide an overview and to foresee future developments and collaborations in this region. Recent findings Total 71 ITx were performed in 67 patients. Living donor ITx was most commonly conducted in Japan (n = 13). Despite the low caseload, all three countries demonstrated acceptable patient survival rates of approximately 70% at 5 years. Over 70% of recipients with a functioning graft were free from total parenteral nutriti...
Source: Current Opinion in Organ Transplantation - Category: Surgery Tags: SMALL BOWEL TRANSPLANTATION: Edited by Cal S. Matsumoto Source Type: research
Purpose of review Intestinal transplantations are among the most complex transplantations, which are performed in few centers in the world. When patients develop intestinal failure, different treatment modalities including parenteral nutrition, autologous gastrointestinal tract reconstructive surgery, and intestinal transplantations are considered. The Middle East is a region where reports on intestinal failures and intestinal transplantations are mainly lacking. In the present review, we highlighted the status of intestinal transplantations in the Middle East and focused on existing reports from this region. Recent fin...
Source: Current Opinion in Organ Transplantation - Category: Surgery Tags: SMALL BOWEL TRANSPLANTATION: Edited by Cal S. Matsumoto Source Type: research
Purpose of review Latin America and the Caribbean represent a vast territory, with very different economic and healthcare realities, which result in significant disparities in the management of intestinal failure patients throughout the region. Since 1968, multiple attempts have been done to accomplish a successful intestinal transplant; but it was not until 2004, with the establishment of multidisciplinary programs, that large series with long-term results could be obtained. Currently, three countries (Colombia, Argentina, and Brazil) in the region are actively performing these procedures. Recent findings A total num...
Source: Current Opinion in Organ Transplantation - Category: Surgery Tags: SMALL BOWEL TRANSPLANTATION: Edited by Cal S. Matsumoto Source Type: research
Purpose of review The present review aims to describe in detail the characteristics, outcomes, and recent trends in the field of pediatric intestinal transplantation in the United States. It will examine the route cause and future implications of these developments. The review will draw from recent publications in the field, the Intestinal Transplant Registry, and contemporary data from large U.S. single centers. Recent findings More than 1500 pediatric intestinal transplants have been performed in the United States since 1985, however, over the past decade there have been fewer than 50 transplants/year nationwide. ...
Source: Current Opinion in Organ Transplantation - Category: Surgery Tags: SMALL BOWEL TRANSPLANTATION: Edited by Cal S. Matsumoto Source Type: research
We examined the surgical and nutritional outcomes of adult patients with USBS managed at a single intestinal rehabilitation center.
Source: Surgery - Category: Surgery Authors: Source Type: research
CONCLUSION: Long-term survival following EPS managed conservatively with nutritional support is feasible, with the majority no longer requiring nutritional support and having a quality of life similar to other patients with ESKD. PMID: 32067553 [PubMed - as supplied by publisher]
Source: Peritoneal Dialysis International - Category: Urology & Nephrology Tags: Perit Dial Int Source Type: research
Abstract PURPOSE OF REVIEW: The present review aims to describe in detail the characteristics, outcomes, and recent trends in the field of pediatric intestinal transplantation in the United States. It will examine the route cause and future implications of these developments. The review will draw from recent publications in the field, the Intestinal Transplant Registry, and contemporary data from large U.S. single centers. RECENT FINDINGS: More than 1500 pediatric intestinal transplants have been performed in the United States since 1985, however, over the past decade there have been fewer than 50 transplan...
Source: Current Opinion in Organ Transplantation - Category: Transplant Surgery Authors: Tags: Curr Opin Organ Transplant Source Type: research
Non-tunneled central venous catheters (CVC) are routinely used in patients undergoing allogeneic hematopoietic cell transplantation (HCT) at many centers. CVC serve as venous access for fluid infusions, blood transfusions, the conditioning therapy, the stem cell product, antimicrobial therapy, parenteral nutrition and blood sampling. Thus, CVC are required to last for several weeks during the acute inpatient phase of the HCT process. However, CVC carry a major risk of catheter-related infections, leading to increased morbidity and mortality.
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Source Type: research
More News: Drugs & Pharmacology | Hormones | Nutrition | Parenteral Nutrition | Transplants