Intestinal failure in adults: recommendations from the ESPEN Expert Groups

Pironi, Loris and Corcos, Olivier and Forbes, Alastair and Holst, Mette and Joly, Francisca and Jonkers, Cora and Klek, Stanislaw and Lal, Simon and Reintam Blaser, Annika and Rollins, Katie E. and Sasdelli, Anna S. and Schaffer, Jon and Van Gossum, Andre and Wanten, Geert and Zanfi, Chiara and Lobo, Dileep N. (2018) Intestinal failure in adults: recommendations from the ESPEN Expert Groups. Clinical Nutrition . ISSN 1532-1983

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Abstract

Background and aims:

Intestinal failure (IF) is defined as “the reduction of gut function below the

minimum necessary for the absorption of macronutrients and/or water and electrolytes, such that intravenous supplementation is required to maintain health and/or growth”. Functionally, it may be classified as type I acute intestinal failure (AIF), type II prolonged AIF and type III chronic intestinal failure (CIF) The ESPEN Workshop on IF was held in Bologna, Italy, on 15-16 October 2017 and the aims of this document were to highlight the current state of the art and future directions for research in IF.

Methods:

This paper represents the opinion of experts in the field, based on current evidence. It is not a formal review, but encompasses the current evidence, with emphasis on epidemiology, classification, diagnosis and management.

Results:

IF is the rarest form of organ failure and can result from a variety of conditions that affect gastrointestinal anatomy and function adversely. Assessment, diagnosis, and short and long-term management involves a multidisciplinary team with diverse expertise in the field that aims to reduce complications, increase life expectancy and improve quality of life in patients.

Conclusions:

Both AIF and CIF are relatively rare conditions and most of the published work presents evidence from small, single-centre studies. Much remains to be investigated to improve the diagnosis and management of IF and future studies should rely on multidisciplinary, multicentre and multinational collaborations that gather data from large cohorts of patients. Emphasis should also be placed on partnership with patients, carers and government agencies in order to improve the quality of research that focuses on patient-centred outcomes that will help to improve both outcomes and quality of life in patients with this devastating condition.

Item Type: Article
Keywords: intestinal failure; short bowel syndrome; definitions; management; acute; chronic;
Schools/Departments: University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine > Nottingham Digestive Diseases Centre
Identification Number: https://doi.org/10.1016/j.clnu.2018.07.036
Depositing User: Eprints, Support
Date Deposited: 10 Sep 2018 12:54
Last Modified: 18 Aug 2019 04:30
URI: http://eprints.nottingham.ac.uk/id/eprint/53997

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