Who needs a gut anyway?

Esther Ha Gyeong Park,Stuart J Fergusson,Matthew Wood,Connor Johnston,Jay Roe Tan,Hani Syaza Syahirah Zakaria,Xavier Kai Yang Tay

doi:10.2218/resmedica.v22i1.813

Abstract

This is an up-to-date review on Chronic Intestinal Failure (CIF) and Parenteral Nutrition (PN) as a management strategy for CIF.CIF and long-term PN are important subjects, but are superficially covered in undergraduate curricula due to the perception that they are relatively specialist areas. PN, as well as being a form of acute nutritional support, is used as a life-sustaining measure for patients with CIF due to conditions such as bowel ischaemia and Crohn’s disease. Currently, around 500 patients receive long-term PN in the UK and the numbers are expected to rise with the aging population1. It is a costly service, requiring a multidisciplinary team effort, along with high frequency patient-healthcare interaction.This article aims to discuss the current evidence on the causes, management and prognosis of CIF, with a particular focus on PN as a form of nutritional management. While PN seems to improve the prognosis of patients with CIF from a medical point of view, we will also explore how it affects other aspects of a patient’s life, such as their social life and mental health.

Highlights

Res Medica 2014, Volume 22, Issue 1. This is an up-to-date review on chronic intestinal failure (CIF) and parenteral nutrition (PN) as a management strategy for CIF
As well as being a form of acute nutritional support, PN is used as a life-sustaining measure for patients with CIF due to conditions such as bowel ischaemia and Crohn’s disease (CD)
In the UK, there are currently around 500 patients receiving long-term home parenteral nutrition (HPN) in addition to oral nutrition and artificial enteral nutrition (EN), and the numbers are expected to rise with the ageing population.1It is a costly service requiring a multidisciplinary team effort along with high frequency patient-healthcare interaction

Summary

Introduction

CIF and long-term PN are important subjects but not covered in detail at the undergraduate level due to the perception that it is a relatively specialist area within gastroenterology. It is an essential aspect of gastroenterology, which must be appreciated and understood by the medical student, because of its associated mortality and morbidity. We will discuss the current evidence on the causes, management, and prognosis of CIF, with a particular focus on PN as a form of nutritional management. While PN seems to improve the prognosis of patients with CIF from a medical point of view, we will explore how it affects other aspects of a patient’s life, such as their social life and mental health

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Conclusion