Alimentary TractGlucagon-like peptide 2 improves nutrient absorption and nutritional status in short-bowel patients with no colon☆,☆☆
Section snippets
Patients
Eight patients (5 women and 3 men; mean age 49.2 years; range, 32–62 years) participated in the study. Four patients with intestinal failure had been receiving home parenteral nutrition (HPN) for 8.0 years (range, 4–14 years), had an end-jejunostomy, and had residual jejunum measured intraoperatively from the ligament of Treitz of 30, 40, 90, and 170 cm. The other 4 patients were not receiving HPN, had no colon in continuation, and had 65, 85, 103, and 170 cm of the terminal ileum resected.
Intestinal absorption
The absolute amounts of diet intake, stomal output (i.e., what was malabsorbed) and the calculated amount absorbed (diet minus output) of energy (MJ/day), macronutrients (MJ/day), wet weight (kg/day), and electrolytes (mmol/day) before and after treatment with GLP-2 are shown in Table 1.The relative absorption of these parameters is shown in Figures 1 and 2.
Discussion
Patients with intestinal failure frequently require life-long parenteral nutrition. Although providing good nutritional recovery, the complex technology of HPN reduces the quality of life,26 and serious side effects, such as sepsis, venous thrombosis, and liver disease may occur.27, 28, 29, 30 Small bowel transplantation is an exciting alternative, but many still consider it experimental for most short-bowel patients until it has proven superior to parenteral nutrition in terms of quality of
Acknowledgements
The authors thank Jette Christiansen, Dorte Christensen, Bodil Petersen, Hardi Hansen, and Jan Borg Rasmussen for technical assistance.
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Supported financially by the European Society of Parenteral and Enteral Nutrition Scientific Committee, the Danish Colitis-Crohn Association, Mimi & Victor Larsens Foundation, Løvens Research Foundation, Dr. Sofus Carl Emil Friis & Hustru Olga Doris Friis Foundation, and the Ferring A/S Gastro Prize 2000.
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Address requests for reprints to: Palle Bekker Jeppesen, MD., Ph.D., Department of Medicine CA-2121, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. e-mail: [email protected]; fax: (45) 35452913.