NEW HORIZON FOR TREATMENT IN...
Antonella Diamanti e Teresa Capriati
UO Riabilitazione Nutrizionale Ospedale Bambino Gesù, IRCCS, Roma
Intestinal Failure (IF) is defined as the reduction of intestinal function below the minimum necessary to maintain stable nutritional status and ensure normal growth in the child. The main clinical marker of IF is the need for parenteral nutrition (PN) support which should at least 75% of the caloric intake for at least 1 month or at least 50% for at least 3 months. Half of the cases of IF are determined by Short Bowel Syndrome (SBS); the remaining 50% of the IF cases are patients affected by Pediatric onset forms of Intestinal Pseudobstruction (PIPO) and structural changes of the intestinal surface, whose main forms are represented by Microvillous Inclusion Diseases (MVID) and “tufting” enteropathy (TE). IF management requires a multidisciplinary approach which involves several expertise which should harmonize the various areas of intervention in a tailored way. Many forms of IF can require long-term PN programs. For this reason, particular attention has always been focused to identify drugs that are potentially active in maximizing the absorption and the digestive ability of the intestine. The main targets of pharmacological management in patients with IF have been: to support the enteric trophic effects and to prevent/treat bacterial overgrowth, diarrhea and dysmotility