Parenteral nutrition improves survival in short bowel syndrome

WASHINGTON — Long-term follow-up of patients with short bowel syndrome showed that parenteral nutrition was an effective therapy for syndrome management and improved survival, according to research presented at Digestive Disease Week 2018.

“We did not find an association between length of remaining small intestine, presence of colon, age at initiation of home parenteral nutrition, or presence of a small bowel ostomy and survival,” Jessica Noelting, MD, from the Toronto General Hospital in Canada, said during her presentation. “The survival of patients with short bowel syndrome on home parenteral nutrition is excellent and similar to that which has been shown in European studies.”

To determine the factors associated with survival among patients with short bowel syndrome on home parenteral nutrition, Noelting and colleagues reviewed data from the prospective Canadian Home PN Registry, which was established in 2005.

By September 2017, the registry included 327 patients with short bowel syndrome and known duration of home parenteral nutrition, of whom 218 were still on total parenteral nutrition at study baseline.

Median patient age at the start of parenteral nutrition was 49 years and median duration on home parenteral nutrition was 4 years. Most patients infused 6 nights per week with an average of 1,870 mL per day for a daily energy average of 1,206 calories, providing 72% of a patient’s total energy requirements.

At study end, 5-year survival was 82%. Patients with cancer had a significantly higher rate of mortality (P < .0001).

“With regards to future direction, it will be interesting to see whether survival will improve as we accrue more expertise with parenteral nutrition management and develop new treatments for short bowel syndrome, as well as when we get new ingredients.” – by Talitha Bennett

Reference:

Noelting J, et al. Abstract 754. Presented at: Digestive Disease Week; June 2-5, 2018; Washington, D.C.

Disclosure: Noelting reports she received research support or other financial benefits from Baxter, Calea, Ontario Medical Supply and Shire. Please see the DDW faculty disclosure index for a list of all other authors’ relevant financial disclosures.