Skip to main content
SpringerLink
Log in

Total Parenteral Nutrition and Inflammatory Bowel Disease: Indications, Long term Outcomes, and Complications

  • Chapter
  • First Online:
Nutritional Management of Inflammatory Bowel Diseases

  • 1369 Accesses

Abstract

Intestinal failure is associated with the inability to maintain protein, energy, electrolyte, fluid, or micronutrients balance while receiving a conventional diet. Subsets of inflammatory bowel disease (IBD) patients require total parenteral nutrition (TPN) as a result of extensive small bowel damage, obstruction, or resection that prevents adequate enteral nutrition. In these patients, TPN represents an essential modality to hasten further nutritional deficiency, restore nutritional homeostasis, and prevent long term complications of nutritional deficiency. Specific indications for TPN in IBD include supportive therapy, life sustaining therapy, volume and calorie replacement, perioperative nutritional support, and gut rest. Patients being treated with TPN have been shown to benefit the most from a home parenteral nutrition treatment plan due to its success in avoiding hospitalization and associated costs.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Wilmore DW, Groff DB, Bishop HC, Dudrick SJ. Total parenteral nutrition in infants with catastrophic gastrointestinal anomalies. J Pediatr Surg. 1969;4(2):181–9.

    Article  CAS  PubMed  Google Scholar 

  2. Howard L, Ament M, Fleming CR, Shike M, Steiger E. Current use and clinical outcome of home parenteral and enteral nutrition therapies in the United States. Gastroenterology. 1995;109(2):355–65.

    Article  CAS  PubMed  Google Scholar 

  3. Seminerio JL, Koutroubakis IE, Ramos-Rivers C, Hashash JG, Dudekula A, Regueiro M, et al. Impact of obesity on the management and clinical course of patients with inflammatory bowel disease. Inflamm Bowel Dis. 2015.

    Google Scholar 

  4. Elson CO, Layden TJ, Nemchausky BA, Rosenberg JL, Rosenberg IH. An evaluation of total parenteral nutrition in the management of inflammatory bowel disease. Dig Dis Sci. 1980;25(1):42–8.

    Article  CAS  PubMed  Google Scholar 

  5. Thompson JS, DiBaise JK, Iyer KR, Yeats M, Sudan DL. Postoperative short bowel syndrome. J Am Coll Surg. 2005;201(1):85–9.

    Article  PubMed  Google Scholar 

  6. Andersson H, Bosaeus I, Brummer RJ, Fasth S, Hulten L, Magnusson O, et al. Nutritional and metabolic consequences of extensive bowel resection. Dig Dis. 1986;4(4):193–202.

    Article  CAS  PubMed  Google Scholar 

  7. Carbonnel F, Cosnes J, Chevret S, Beaugerie L, Ngo Y, Malafosse M, et al. The role of anatomic factors in nutritional autonomy after extensive small bowel resection. JPEN J Parenter Enteral Nutr. 1996;20(4):275–80.

    Article  CAS  PubMed  Google Scholar 

  8. Evans JP, Steinhart AH, Cohen Z, McLeod RS. Home total parenteral nutrition: an alternative to early surgery for complicated inflammatory bowel disease. J Gastrointest Surg. 2003;7(4):562–6.

    Article  PubMed  Google Scholar 

  9. Koretz RL, Lipman TO, Klein S, American GA. AGA technical review on parenteral nutrition. Gastroenterology. 2001;121(4):970–1001.

    Article  CAS  PubMed  Google Scholar 

  10. Buchman AL. Glutamine for the gut: mystical properties or an ordinary amino acid? Curr Gastroenterol Rep. 1999;1(5):417–23.

    Article  CAS  PubMed  Google Scholar 

  11. Drucker DJ, Shi Q, Crivici A, Sumner-Smith M, Tavares W, Hill M, et al. Regulation of the biological activity of glucagon-like peptide 2 in vivo by dipeptidyl peptidase IV. Nat Biotechnol. 1997;15(7):673–7.

    Article  CAS  PubMed  Google Scholar 

  12. Jeppesen PB, Gilroy R, Pertkiewicz M, Allard JP, Messing B, O’Keefe SJ. Randomised placebo-controlled trial of teduglutide in reducing parenteral nutrition and/or intravenous fluid requirements in patients with short bowel syndrome. Gut. 2011;60(7):902–14.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Berg JK, Kim EH, Li B, Joelsson B, Youssef NN. A randomized, double-blind, placebo-controlled, multiple-dose, parallel-group clinical trial to assess the effects of teduglutide on gastric emptying of liquids in healthy subjects. BMC Gastroenterol. 2014;14:25.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Buchman AL, Katz S, Fang JC, Bernstein CN, Abou-Assi SG, Teduglutide Study Group. Teduglutide, a novel mucosally active analog of glucagon-like peptide-2 (GLP-2) for the treatment of moderate to severe Crohn’s disease. Inflamm Bowel Dis. 2010;16(6):962–73.

    Article  PubMed  Google Scholar 

  15. Shivananda S, Hordijk ML, Pena AS, Mayberry JF. Crohn’s disease: risk of recurrence and reoperation in a defined population. Gut. 1989;30(7):990–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Ostro MJ, Greenberg GR, Jeejeebhoy KN. Total parenteral nutrition and complete bowel rest in the management of Crohn’s disease. JPEN J Parenter Enteral Nutr. 1985;9(3):280–7.

    Article  CAS  PubMed  Google Scholar 

  17. Wistbacka JO, Nuutinen LS. Catheter-related complications of total parenteral nutrition (TPN): a review. Acta Anaesthesiol Scand Suppl. 1985;82:84–8.

    Article  CAS  PubMed  Google Scholar 

  18. Eisen LA, Narasimhan M, Berger JS, Mayo PH, Rosen MJ, Schneider RF. Mechanical complications of central venous catheters. J Intensive Care Med. 2006;21(1):40–6.

    Article  PubMed  Google Scholar 

  19. Buchman AL, Misra S, Moukarzel A, Ament ME. Catheter thrombosis and superior/inferior vena cava syndrome are rare complications of long term parenteral nutrition. Clin Nutr. 1994;13(6):356–60.

    Article  CAS  PubMed  Google Scholar 

  20. Flinterman LE, Van Der Meer FJ, Rosendaal FR, Doggen CJ. Current perspective of venous thrombosis in the upper extremity. J Thromb Haemost. 2008;6(8):1262–6.

    Article  CAS  PubMed  Google Scholar 

  21. Werlin SL, Lausten T, Jessen S, Toy L, Norton A, Dallman L, et al. Treatment of central venous catheter occlusions with ethanol and hydrochloric acid. JPEN J Parenter Enteral Nutr. 1995;19(5):416–8.

    Article  CAS  PubMed  Google Scholar 

  22. Yaacob Y, Zakaria R, Mohammad Z, Ralib AR, Muda AS. The vanishing veins: difficult venous access in a patient requiring translumbar, transhepatic, and trans collateral central catheter insertion. Malays J Med Sci. 2011;18(4):98–102.

    PubMed  PubMed Central  Google Scholar 

  23. Bosonnet L. Total parenteral nutrition: how to reduce the risks. Nurs Times. 2002;98(22):40–3.

    PubMed  Google Scholar 

  24. Reed CR, Sessler CN, Glauser FL, Phelan BA. Central venous catheter infections: concepts and controversies. Intensive Care Med. 1995;21(2):177–83.

    Article  CAS  PubMed  Google Scholar 

  25. Maki DG, Weise CE, Sarafin HW. A semiquantitative culture method for identifying intravenous-catheter-related infection. N Engl J Med. 1977;296(23):1305–9.

    Article  CAS  PubMed  Google Scholar 

  26. Mermel LA, Allon M, Bouza E, Craven DE, Flynn P, O’Grady NP, et al. Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis. 2009;49(1):1–45.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Anderson RA. Chromium, glucose intolerance and diabetes. J Am Coll Nutr. 1998;17(6):548–55.

    Article  CAS  PubMed  Google Scholar 

  28. Mehanna HM, Moledina J, Travis J. Refeeding syndrome: what it is, and how to prevent and treat it. BMJ. 2008;336(7659):1495–8.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Reuler JB, Girard DE, Cooney TG. Current concepts. Wernicke’s encephalopathy. N Engl J Med. 1985;312(16):1035–9.

    Article  CAS  PubMed  Google Scholar 

  30. Montalvo-Jave EE, Zarraga JL, Sarr MG. Specific topics and complications of parenteral nutrition. Langenbecks Arch Surg. 2007;392(2):119–26.

    Article  PubMed  Google Scholar 

  31. Grzegorzewska I, Czarnecki A. The influence of electrolytes on fat emulsions stability in total parenteral nutrition mixtures. Acta Pol Pharm. 1995;52(1):17–20.

    CAS  PubMed  Google Scholar 

  32. Al-Jurf AS, Chapmann-Furr F. Phosphate balance and distribution during total parenteral nutrition: effect of calcium and phosphate additives. JPEN J Parenter Enteral Nutr. 1986;10(5):508–12.

    Article  CAS  PubMed  Google Scholar 

  33. Forrest EH, Oien KA, Dickson S, Galloway D, Mills PR. Improvement in cholestasis associated with total parenteral nutrition after treatment with an antibody against tumour necrosis factor alpha. Liver. 2002;22(4):317–20.

    Article  PubMed  Google Scholar 

  34. Grau T, Bonet A, Rubio M, Mateo D, Farre M, Acosta JA, et al. Liver dysfunction associated with artificial nutrition in critically ill patients. Crit Care. 2007;11(1):R10.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Buchman AL, Moukarzel AA, Bhuta S, Belle M, Ament ME, Eckhert CD, et al. Parenteral nutrition is associated with intestinal morphologic and functional changes in humans. JPEN J Parenter Enteral Nutr. 1995;19(6):453–60.

    Article  CAS  PubMed  Google Scholar 

  36. Tompkins RK, Waisman J, Watt CM, Corlin R, Keith R. Absence of mucosal atrophy in human small intestine after prolonged isolation. Gastroenterology. 1977;73(6):1406–9.

    CAS  PubMed  Google Scholar 

  37. Howard L. Home parenteral nutrition: survival, cost, and quality of life. Gastroenterology. 2006;130(2 Suppl 1):S52–9.

    Article  CAS  PubMed  Google Scholar 

  38. Baptista RJ, Lahey MA, Bistrian BR, Champagne CD, Miller DG, Kelly SE, et al. Periodic reassessment for improved, cost-effective care in home total parenteral nutrition: a case report. JPEN J Parenter Enteral Nutr. 1984;8(6):708–10.

    Article  CAS  PubMed  Google Scholar 

  39. Jeppesen PB, Langholz E, Mortensen PB. Quality of life in patients receiving home parenteral nutrition. Gut. 1999;44(6):844–52.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Detsky AS, McLaughlin JR, Abrams HB, L’Abbe KA, Whitwell J, Bombardier C, et al. Quality of life of patients on long-term total parenteral nutrition at home. J Gen Intern Med. 1986;1(1):26–33.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh School of Medicine, UPMC Presbyterian Hospital, 200 Lothrop Street, Pittsburgh, PA, 15143, USA

    Priya Loganathan M.B.B.S., Alyce Anderson B.S., William Rivers B.S., Claudia Ramos Rivers M.D. & David G. Binion M.D.

  2. Department of Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Mahesh Gajendran M.B.B.S.

Authors
  1. Priya Loganathan M.B.B.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alyce Anderson B.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. William Rivers B.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Claudia Ramos Rivers M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mahesh Gajendran M.B.B.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. David G. Binion M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to David G. Binion M.D. .

Editor information

Editors and Affiliations

  1. Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA

    Ashwin N. Ananthakrishnan

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Loganathan, P., Anderson, A., Rivers, W., Rivers, C.R., Gajendran, M., Binion, D.G. (2016). Total Parenteral Nutrition and Inflammatory Bowel Disease: Indications, Long term Outcomes, and Complications. In: Ananthakrishnan, A. (eds) Nutritional Management of Inflammatory Bowel Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-26890-3_9

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-26890-3_9

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-26888-0

  • Online ISBN: 978-3-319-26890-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation