define intestinal failure
the reduction in function below the minimum necessary for the absorption of macronutrients and/or water and electrolytes such that intravenous supplementation is required to maintain health and/or growth
what is intestinal failure a result of?
results from inability to maintain adequate nutrition or fluid status via the intestines
how does intestinal failure occur?
can occur due to obstruction, dysmotility , surgical resection, congenital defect, or disease associated loss of aborption.
what are the main characteristics of intestinal failure?
the inability to maintain protein-energy, fluid, electrolyte, or macronutrient balance
what is acute intestinal failure
2 weeks eg mucositis post chemo
type 1 and 2
what is chronic intestinal failure?
eg short gut syndrome
type 3
what is type 1 intestinal failure?
- self-limiting intestinal failure
- wards (HDU/ICU)
what is type 2 intestinal failure?
- significant and prolonged PN support (>28 days)
- HDU/ICU
what is type 3 intestinal failure?
- chronic IF
- long term PN support
- wards to home
what is the treatment of type 1 intestinal failure?
- replace fluid, correct electolytes
- acid suppression (PPIs)
- octreotide
- alpha hydroxycholecalciferol to preserve Mg
- allow some diet, enteral feeding
what is the treatment of type 2 intestinal failure?
- some enteral feeding
- operation
- weeks/months of care
what is the treatment of type 3 intestinal failure?
- home parenteral nutrition
- intestinal transplantation
- glucagon like peptide-2 (tedglutide)
- bowel lengthening
what is short bowel syndrome?
<200cm
insufficient length of small bowel to meet nutritional needs without artificial nutritional support
what are the types of short bowel syndrome?
- jejunostomy
- ileostomy
- jejuno-colic anastamosis
- ileo-colic anastamosis
what is peripheral parenteral nutrition?
PPN
- through largest veins in arms
- blue 22G PVC
what is central parenteral nutrition?
- PICC ( peripherally inserted catheter) 14 days
- tunnelled catheter (hickman line)
- vascuport
- ultrasound guided
what are the complications of central parenteral nutrition?
- pneumothorax
- arterial puncture
- misplacement
what are general complications of parenteral nutrition?
- sepsis
- SVC thrombosis
- line fracture
- line leakage
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Pharmacology34
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Biochemistry38
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Anatomy130
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Oral Disease18
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Upper GI Disease21
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Dyspepsia11
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Oral Pre-malignancy + Cancer5
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Upper GI Bleeding11
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IBD81
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Small Bowel Disease21
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Malabsorption13
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Malnutrition13
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Endoscopes1
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Intestinal Failure18
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Colorectal Pathology14
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Benign Conditions of Large Bowel23
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Microbiology9
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Functional Gut Disorders14
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STIs of GI Tract0
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Colorectal Cancer16
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Drugs and Liver Disease0
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The Pancreas0
