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2025, Number 3

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Cir Gen 2025; 47 (3)

Intestinal failure

Medina LJL

Language: Spanish
References: 16
Page: 174-183
PDF size: 331.14 Kb.


ABSTRACT

Intestinal failure is defined by the ESPEN Guidelines, in their latest 2023 update, as a reduction in intestinal function below the minimum necessary for the absorption of macronutrients, water, and electrolytes, such that intravenous supplementation is necessary to maintain the health and growth necessary for the organism. The etiology of intestinal failure can be acquired or congenital, gastrointestinal or systemic, benign or malignant, and affects any age group from birth to adulthood. The most common etiologies are inflammatory bowel diseases and multifactorial mesenteric ischemia. Inflammatory bowel diseases are increasing in prevalence worldwide. They can be divided into Crohn's disease and inflammatory conditions of the entire gastrointestinal tract, or ulcerative colitis, which predominantly affects the large intestine. Risk factors for these phenomena include younger age at diagnosis or at first surgery, ileocolonic and perianal disease, a family history of inflammatory bowel diseases, and smoking. Recent data report significant variation in the prevalence of intestinal failure worldwide. In the United States, the estimated prevalence of patients dependent on home parenteral nutrition in 2013 was 79:1'000,000 of the population, similar to that reported in Denmark. Nutrition is the cornerstone therapy in this group of patients, so it is necessary to know the precise indications for enteral and parenteral nutrition. Surgical treatment is complex and must be performed by highly experienced physicians. Intestinal transplantation has recently appeared to be promising.


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