ReviewShort Bowel Syndrome and Intestinal Failure: Consensus Definitions and Overview
Section snippets
Incidence
The true incidence of SBS and intestinal failure in the United States is unknown, in part because of the lack of precise definitions. Surveys of clinicians have produced variable figures; some practicing gastroenterologists report never having seen a patient with SBS. Undoubtedly, some of their patients are those who have had minor, well-tolerated resections, and who thus do not require therapy. Registries of home TPN patients generally produce incidence figures representing the severe end of
Evolution of Definitions: Short Bowel Syndrome and Intestinal Failure
The reported “normal” length of the small intestine varies considerably from 300–850 cm.1, 16 Although evidence suggests that patients with less than 200 cm of small bowel are likely to develop intestinal failure, this number is of little use in clinical practice, because outcome depends on the prognostic factors already mentioned, important among which are the quality of bowel remaining and whether the large bowel has been conserved. For example, loss of bowel in a patient with Crohn’s disease
Proposed New Definitions
Recognizing the limitations and overlap in current definitions of conditions related to short bowel and intestinal failure, our group convened for the purpose of developing consensus definitions for both intestinal failure and SBS-associated intestinal failure to help practicing gastroenterologists categorize patients with short bowel and to provide uniformity of view when registering such patients with regulatory authorities or assessing their response to novel forms of therapy. The panel
Conclusions
Consensus working definitions of SBS and intestinal failure have been proposed in this review to help the practicing gastroenterologist manage patients with intestinal failure caused by massive intestinal loss and, at the same time, to help in the evaluation of novel pharmacologic therapies.
References (25)
- et al.
AGA technical review on short bowel syndrome and intestinal transplantation
Gastroenterology
(2003) - et al.
Long-term survival and parenteral nutrition dependence in adult patients with the short bowel syndrome
Gastroenterology
(1999) - et al.
Digestion and absorption after massive resection of the small intestinepart 2
Gastroenterology
(1950) How adaptable is the intestine in patients with short-bowel syndrome?
Am J Clin Nutr
(2002)- et al.
Jejunal efflux in short bowel syndrome
Lancet
(1990) - et al.
Long-acting somatostatin analogue and protein metabolism in patients with jejunostomies
Gastroenterology
(1994) The medical and surgical management of short bowel syndrome
Med Gen Med
(2004)Short bowel syndromea nutritional and medical approach
CMAJ
(2002)North American homeparenteral and enteral nutrition patient registry annual report
(1994)Short bowel syndrome and intestinal transplantationmedical position statement
Gastroenterology
(2003)
The role of anatomic factors in nutritional autonomy after extensive small bowel resection
JPEN J Parenter Enteral Nutr
Colonic preservation reduces need for parenteral therapy, increases incidence of renal stones, but does not change high prevalence of gall stones in patients with a short bowel
Gut
Cited by (413)
Evaluation of the Effectiveness of Teduglutide Treatment in Patients with Short Bowel Syndrome in Slovakia—Multicenter Real-World Study
2024, Journal of Clinical MedicineNutrition care for the adult post–intestinal transplant patient
2024, Nutrition in Clinical Practice
Dr Jeppesen has served as a consultant for NPS Pharmaceuticals.
Funding for the meeting of the panel of experts was provided by NPS Pharmaceuticals, Salt Lake City, Utah. The views contained are solely those of the expert panel.