Abstract：
BACKGROUND/OBJECTIVES:Patients with a short bowel and receiving parenteral nutrition (PN) have an increased risk of chronic cholestasis (CC). Restoration of bowel continuity after a mesenteric infarction results in PN requirements being reduced or stopped. This study aimed to determine the prevalence of CC and whether restoring bowel continuity reduced the risk of CC. SUBJECTS/METHODS:A retrospective review of patients with a short bowel owing to mesenteric infarction from 2000 to 2012. CC was defined as two of bilirubin, alkaline phosphatase and gamma-glutamyl transferase being 1.5 times the upper limit of normal for >6 months. RESULTS:We identified 104 (55 females, median age 54 years) patients. Seventy-three (70%) patients had restoration of bowel continuity; of these, 25 (34%) had abnormal liver biochemistry (liver function test (LFT)), with 15 (21%) having CC. Following restoration of bowel continuity, 8 (53%) of 15 patients with CC and 10 (100%) of 10 patients with abnormal LFT but not CC had a return of liver function within normal range within a year. Univariate analysis showed restoring bowel continuity (P=0.002) and cessation of PN (P=0.006) were associated with a reduction in prevalence of CC. Multivariate analysis showed that cessation of PN was a significant factor in reducing CC (P=0.02). CONCLUSIONS:The prevalence of CC is 29% for patients with a short bowel receiving PN following a mesenteric infarction. CC resolves in 53% after continuity is restored, and this is most likely due to stopping or reducing the PN.
journal_name
Eur J Clin Nutrjournal_title
European journal of clinical nutritionauthors
Adaba F,Uppara M,Iqbal F,Mallappa S,Vaizey CJ,Gabe SM,Warusavitarne J,Nightingale JMdoi
10.1038/ejcn.2015.147subject
Has Abstractpub_date
2016-02-01 00:00:00pages
189-93issue
2eissn
0954-3007issn
1476-5640pii
ejcn2015147journal_volume
70pub_type
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