9 results on '"Short bowel syndrome"'
Search Results
2. Cumulative Inflammation Could Be a Risk Factor for Intestinal Failure in Crohn's Disease.
- Author
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Watanabe, Yoshifumi, Miyoshi, Norikatsu, Fujino, Shiki, Takahashi, Hidekazu, Haraguchi, Naotsugu, Hata, Taishi, Matsuda, Chu, Yamamoto, Hirofumi, Doki, Yuichiro, Mori, Masaki, and Mizushima, Tsunekazu
- Subjects
- *
CROHN'S disease , *SHORT bowel syndrome , *DISEASE risk factors , *DISEASE duration , *INFLAMMATION , *NOSOLOGY - Abstract
Background: Intestinal failure is the most critical complication of Crohn's disease. Intestinal failure requires home parenteral nutrition, which worsens the quality of life of the patients and sometimes causes life-threatening complications.Aims: The purpose of this study was to investigate the incidence and risk factors for intestinal failure in Crohn's disease.Methods: We performed a retrospective analysis of Crohn's disease patients (162 cases) at Osaka University Hospital between January 2000 and December 2017. Kaplan-Meier analysis was used to investigate the cumulative incidence of intestinal failure. To identify the risk factors of intestinal failure, patient characteristics were analyzed by multivariate analysis, including disease classification, surgical history, medical treatment other than surgery, and cumulative inflammation was calculated using the average C-reactive protein value and disease duration.Results: The cumulative incidence of intestinal failure 5, 10, and 15 years after Crohn's disease diagnosis was 2.6%, 3.4%, and 8.6%, respectively. Multivariate analysis identified the following as independent risk factors for intestinal failure in Crohn's disease: residual small intestinal length < 200 cm (odds ratio 7.51, 95% confidence interval 2.14-29.96), non-use of anti-tumor necrosis factor-alpha therapy (3.34, 1.22-10.74), and cumulative inflammation (1.01, 1.001-1.038). We created a new predictive nomogram consisting of these risk factors.Conclusions: Intestinal failure occasionally occurred during long-term treatment of Crohn's disease. Cumulative inflammation for the first time, in addition to short residual small intestinal length and non-use of anti-tumor necrosis factor-alpha therapy, was shown to be potential risk factors for intestinal failure in Crohn's disease. [ABSTRACT FROM AUTHOR]- Published
- 2019
- Full Text
- View/download PDF
3. Off-Label Teduglutide Therapy in Non-intestinal Failure Patients with Chronic Malabsorption.
- Author
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George, Alvin T., Li, Betty H., and Carroll, Robert E.
- Subjects
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SHORT bowel syndrome , *CROHN'S disease , *PRESSURE ulcers , *PARENTERAL feeding , *SMALL intestine , *CHRONIC diseases , *GASTROINTESTINAL agents , *INTESTINAL absorption , *MALABSORPTION syndromes , *MEDICAL prescriptions , *MENTAL health surveys , *PEPTIDES , *WEIGHT gain , *TREATMENT effectiveness , *NUTRITIONAL status , *ARTHRITIS Impact Measurement Scales - Abstract
Background: Teduglutide, a glucagon-like peptide 2 analog, has demonstrated efficacy in treating adult patients with short bowel syndrome (SBS) and dependence on parenteral nutrition (PN), but its role in chronic malabsorptive states that do not necessitate PN remains uncertain.Aims: To evaluate teduglutide use beyond its approved indications and to discuss the results of this adjunctive treatment in patients resistant to established therapy.Results: This series reports four patients treated with teduglutide off-label. The first case had Crohn's disease (CD) with persistent colocutaneous fistulae that demonstrated complete closure after 8 months of teduglutide therapy. The second case involved a PN-dependent CD patient with persistent fistulae and intra-abdominal abscesses who weaned off PN and had a significant improvement in her nutritional status after 3 months of teduglutide therapy. The third case had CD complicated by severe malnutrition and previous PN-associated line infections, but by 9 months of teduglutide therapy, she gained 5 kg and no longer required re-initiation of PN. The fourth case had a high-output diverting ileostomy with resultant impaired healing of a stage IV decubitus ulcer, and after 2 months of therapy, the patient's pre-albumin increased by 250% and the ulcer had decreased by 40% in size.Conclusion: The use of teduglutide might be broadened to include patients with functional SBS not meeting strict criteria for intestinal failure. Further studies should evaluate the efficacy of teduglutide in patients who may require short-term small intestine rehabilitation or who have chronically impaired absorptive capacity not yet requiring PN. [ABSTRACT FROM AUTHOR]- Published
- 2019
- Full Text
- View/download PDF
4. Patent Issued for GLP-2 analogs and peptibodies for administration before, during or after surgery (USPTO 11660328).
- Subjects
PATENT offices ,DIGESTIVE system diseases ,CROHN'S disease ,CD26 antigen ,SHORT bowel syndrome - Abstract
A method of treating a patient who has undergone surgery and has short bowel syndrome comprising administering a GLP-2 peptibody to the patient within a period of 48 hours after surgery, wherein the GLP-2 peptibody comprises one of the sequences set forth in SEQ ID NO: 2-16. Keywords: Business; Crohn's Disease; Diet and Nutrition; Digestive System Diseases and Conditions; Drugs and Therapies; Feeding Methods; Gastroenteritis; Gastroenterology; Gastrointestinal; Gastrointestinal Diseases and Conditions; Health and Medicine; Malabsorption Syndromes; Nutritional Support; Parenteral Nutrition; Peptides; Pharmaceutical Companies; Proteins; Proteomics; Short Bowel Syndrome; Surgery; Takeda Pharmaceutical Company Limited; Volvulus EN Business Crohn's Disease Diet and Nutrition Digestive System Diseases and Conditions Drugs and Therapies Feeding Methods Gastroenteritis Gastroenterology Gastrointestinal Gastrointestinal Diseases and Conditions Health and Medicine Malabsorption Syndromes Nutritional Support Parenteral Nutrition Peptides Pharmaceutical Companies Proteins Proteomics Short Bowel Syndrome Surgery Takeda Pharmaceutical Company Limited Volvulus 2034 2034 1 06/19/23 20230620 NES 230620 2023 JUN 19 (NewsRx) -- By a News Reporter-Staff News Editor at Pharma Business Week -- Takeda Pharmaceutical Company Limited (Osaka, Japan) has been issued patent number 11660328, according to news reporting originating out of Alexandria, Virginia, by NewsRx editors. "In some embodiments, the h(Gly2)GLP-2, a GLP-2 analog, and/or a GLP-2 peptibody is administered to the patient 24 hours after surgery, 18 hours after surgery, 12 hours after surgery, 9 hours after surgery, 6 hours after surgery, three hours after surgery, two hours after surgery, or one hour after surgery. [Extracted from the article]
- Published
- 2023
5. Off-Label Teduglutide Therapy in Non-intestinal Failure Patients with Chronic Malabsorption
- Author
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Robert J. Carroll, Alvin T. George, and Betty Li
- Subjects
Adult ,Male ,medicine.medical_specialty ,Malabsorption ,Physiology ,Nutritional Status ,Disease ,Weight Gain ,Teduglutide ,Gastroenterology ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Gastrointestinal Agents ,Malabsorption Syndromes ,Risk Factors ,Internal medicine ,medicine ,Humans ,Aged ,Crohn's disease ,business.industry ,Off-Label Use ,Hepatology ,Middle Aged ,medicine.disease ,Short bowel syndrome ,Parenteral nutrition ,Treatment Outcome ,chemistry ,Intestinal Absorption ,030220 oncology & carcinogenesis ,Adjunctive treatment ,Chronic Disease ,030211 gastroenterology & hepatology ,Female ,business ,Peptides - Abstract
Teduglutide, a glucagon-like peptide 2 analog, has demonstrated efficacy in treating adult patients with short bowel syndrome (SBS) and dependence on parenteral nutrition (PN), but its role in chronic malabsorptive states that do not necessitate PN remains uncertain. To evaluate teduglutide use beyond its approved indications and to discuss the results of this adjunctive treatment in patients resistant to established therapy. This series reports four patients treated with teduglutide off-label. The first case had Crohn’s disease (CD) with persistent colocutaneous fistulae that demonstrated complete closure after 8 months of teduglutide therapy. The second case involved a PN-dependent CD patient with persistent fistulae and intra-abdominal abscesses who weaned off PN and had a significant improvement in her nutritional status after 3 months of teduglutide therapy. The third case had CD complicated by severe malnutrition and previous PN-associated line infections, but by 9 months of teduglutide therapy, she gained 5 kg and no longer required re-initiation of PN. The fourth case had a high-output diverting ileostomy with resultant impaired healing of a stage IV decubitus ulcer, and after 2 months of therapy, the patient’s pre-albumin increased by 250% and the ulcer had decreased by 40% in size. The use of teduglutide might be broadened to include patients with functional SBS not meeting strict criteria for intestinal failure. Further studies should evaluate the efficacy of teduglutide in patients who may require short-term small intestine rehabilitation or who have chronically impaired absorptive capacity not yet requiring PN.
- Published
- 2018
6. Jejunal interposition for short bowel syndrome in a septuagenarian.
- Author
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Gee, Tikfu, Lim, Shu Yu, Sudhakaran, Nadarajan, and Hassan, Muhammad Firdaus
- Subjects
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SHORT bowel syndrome , *INTESTINAL surgery , *CROHN'S disease , *MALABSORPTION syndromes , *PARENTERAL feeding , *WEIGHT loss - Abstract
Short bowel syndrome in adults occurs as a result of massive small intestinal resection commonly due to severe Crohn's disease, volvulus or tumors. Diarrhea and weight loss are hallmarks of malabsorption which are aggravated if the colon is removed along with the small intestinal resection. Enteral nutrition autonomy is difficult to achieve in such cases of malabsorption where parenteral nutrition are required more often than not. We report a case of short bowel syndrome with severe malabsorption following extensive small bowel removal. The patient eventually underwent intestinal rehabilitation surgery and achieved independence from parenteral nutrition. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
7. Chronic Intestinal Pseudo-Obstruction in Patients with Extensive Bowel Resection for Crohn's Disease
- Author
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K Ladefoged, T Myrhøj, and S Jarnum
- Subjects
Adult ,Reoperation ,Intestinal pseudo-obstruction ,medicine.medical_specialty ,Malabsorption ,medicine.medical_treatment ,Gastroenterology ,Jejunum ,Postoperative Complications ,Crohn Disease ,Malabsorption Syndromes ,Recurrence ,Internal medicine ,Intestine, Small ,medicine ,Humans ,Intestine, Large ,Crohn's disease ,business.industry ,Bowel resection ,Short bowel syndrome ,medicine.disease ,Surgery ,Radiography ,medicine.anatomical_structure ,Parenteral nutrition ,Vomiting ,Female ,medicine.symptom ,business ,Intestinal Obstruction - Abstract
We report three cases of severe chronic intestinal pseudo-obstruction after extensive bowel resection for Crohn's disease. The patients retained less than or equal to 150 cm jejunum in continuity with the left half of the colon and had no evidence of inflammatory activity in the remaining bowel. Total parenteral nutrition was required, since even very small meals caused abdominal distention, pain, and vomiting. Two patients had a sigmoidostomy constructed, which alleviated the symptoms and enabled a normal oral intake, but only temporarily in one of the patients. Even with a sigmoidostomy the patients needed supplementary parenteral nutrition because of severe malabsorption with high stomal output.
- Published
- 1988
8. Effect of a long acting somatostatin analogue SMS 201-995 on jejunostomy effluents in patients with severe short bowel syndrome
- Author
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K C Christensen, J. Hegnhøj, S Jarnum, and K Ladefoged
- Subjects
Adult ,Diarrhea ,Male ,Short Bowel Syndrome ,medicine.medical_specialty ,Letter ,Malabsorption ,medicine.medical_treatment ,Jejunostomy ,Octreotide ,Gastroenterology ,Intestinal absorption ,Ileostomy ,Double-Blind Method ,Malabsorption Syndromes ,Internal medicine ,medicine ,Humans ,Aged ,Clinical Trials as Topic ,Crohn's disease ,business.industry ,Middle Aged ,medicine.disease ,Short bowel syndrome ,Surgery ,Parenteral nutrition ,Intestinal Absorption ,Female ,business ,Research Article ,medicine.drug - Abstract
The effect of a long acting somatostatin analogue SMS 201-995 on stomal effluents in patients with severe short bowel syndrome was investigated in a double blind placebo controlled balance study. Six patients, five with Crohn's disease and one with radiation enteropathy were studied. Five patients had a jejunostomy and one an ileostomy. The patients had a normal food intake, but because of severe malabsorption had received home parenteral nutrition for several years. Faecal mass was reduced (p less than 0.005) and intestinal net sodium absorption was increased (p less than 0.005) by intravenous infusion of SMS 25 micrograms/h. Net absorption of potassium, calcium, magnesium phosphate, zinc, nitrogen and fat was not influenced. Subcutaneous injections of 50 micrograms SMS every 12 hours had a similar effect on net intestinal absorption of sodium and water. Four patients continued with a five to six months open follow up study when subcutaneous SMS in the same dose was administered by the patients at home. The effect on faecal sodium loss persisted, but in one patient faecal mass gradually increased and finally exceeded pretreatment values. SMS may decrease net absorption of water and sodium following reduced secretion of digestive juices rather than by increasing absorptive capacity. SMS may be useful as an antidiarrhoeal drug in patients with high output jejuno- or ileostomies, but in patients who need permanent parenteral nutrition the effect is too small to significantly alter management.
- Published
- 1989
9. Strategies for preserving intestinal length in the short-bowel syndrome
- Author
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Jons S. Thompson
- Subjects
Male ,Short Bowel Syndrome ,medicine.medical_specialty ,medicine.medical_treatment ,Perforation (oil well) ,Malabsorption Syndromes ,medicine ,Radiation Enteritis ,Strictureplasty ,Intestinal Fistula ,Methods ,Humans ,Child ,Radiation Injuries ,Aged ,Crohn's disease ,business.industry ,Intestinal atresia ,Gastroenterology ,food and beverages ,General Medicine ,Jejunal Diseases ,Middle Aged ,medicine.disease ,Short bowel syndrome ,Colorectal surgery ,Surgery ,Intestines ,Parenteral nutrition ,Intestinal Perforation ,Female ,business ,Intestinal Obstruction - Abstract
Total parenteral nutrition now permits long-term survival in patients after massive intestinal resection. Surgical therapy for the short-bowel syndrome is still largely experimental and cannot be recommended routinely. Thus, prevention of intestinal resection and conservation of intestinal length, when resection is necessary, should be emphasized. Strategies are presented that can be employed to preserve intestinal length when surgery is required in patients with a shortened bowel. These include strictureplasty, minimal resection, serosal patching, and intestinal tapering. In suitable candidates strictureplasty can relieve obstruction from strictures while avoiding resection. Minimal resection of involved intestine can be performed safely in selected patients with radiation injury or Crohn's disease. Serosal patching is an alternative to resection for the treatment of perforation or strictures of the intestine. Intestinal tapering can improve the function of dilated intestinal segments and eliminate the need for resection in intestinal atresia. The judicious use of these procedures can preserve intestinal length and obviate the need for long-term parenteral nutrition in patients after massive intestinal resection.
- Published
- 1987
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