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. 2024 Sep 30;16(19):3311.
doi: 10.3390/nu16193311.

The Epidemiology and Clinical Management of Short Bowel Syndrome and Chronic Intestinal Failure in Crohn's Disease in Italy: An IG-IBD Survey

Tommaso Pessarelli  1 , Matilde Topa  1 , Andrea Sorge  1 , Nicoletta Nandi  1 , Daniela Pugliese  2 , Fabio Salvatore Macaluso  3 , Ambrogio Orlando  3 , Simone Saibeni  4 , Andrea Costantino  1   5 , Francesco Stalla  6 , Valentina Zadro  7 , Lucia Scaramella  5 , Maurizio Vecchi  1   5 , Flavio Caprioli  1   5 , Luca Elli  1   5
Affiliations

The Epidemiology and Clinical Management of Short Bowel Syndrome and Chronic Intestinal Failure in Crohn's Disease in Italy: An IG-IBD Survey

Tommaso Pessarelli et al. Nutrients. .

Abstract

Background/objectives: Limited data exist on the epidemiology and clinical management of short bowel syndrome (SBS) and chronic intestinal failure (CIF) in Crohn's disease (CD). This study aimed to evaluate these aspects in Italy.

Methods: Members of the Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD) were invited to complete a cross-sectional web survey. A subgroup analysis examined the influence of different clinical settings on SBS and CIF management in CD.

Results: A total of 47/128 (36.7%) IG-IBD centers participated. Among them, 31.9% were teduglutide (TED) prescribers, and 48.9% were academic centers. The median estimated prevalence of CIF among small bowel CD patients was 1%, and it was significantly higher in academic centers (2.0% [IQR 1-5%] vs. 0.13% [IQR 0-1%], p = 0.02). Seventy-eight percent of centers managed fewer than 10 SBS and CD patients. Routine small bowel measurement and nutritional assessment were performed in only 15% and 42.6% of centers, respectively. TED was prescribed by 12 centers to 35 patients, with a treatment success rate exceeding 50% in 81.8% of centers.

Conclusions: The estimated prevalence of CIF in CD patients with small bowel involvement in Italy is 1%. The diagnosis and management practices for SBS and CIF are suboptimal, and TED use is limited.

Keywords: SBS in CD; intestinal failure in Crohn’s disease; prevalence of short bowel in Crohn; short bowel syndrome in Crohn’s disease.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
On the left, the geographical distribution of the 47 study participant centers; on the right, in red are identified the teduglutide-prescribing sites.
Figure 2
Figure 2
Estimated prevalence of intestinal failure in CD with small bowel involvement in all centers (panel A) and in academic vs. non-academic centers (panel B). ° and *: two outliers among non-academic centers.
Figure 3
Figure 3
A cake graphic in which the responding centers are divided into four groups, according to the number of patients with SBS and CD with small bowel involvement reported to be followed in each center. The graphic outlines how most of the centers reported to follow less than 10 patients with SBS and CD, underlining the scanty centralization of patients affected by these conditions.
Figure 4
Figure 4
Percentage of patients undergoing direct surgical (panel A), radiological (panel B), or indirect (panel C) residual small bowel measurement in SBS and CD. SB: small bowel.
Figure 5
Figure 5
Nutritional referral in CD with small bowel involvement and CIF: overall data.
See this image and copyright information in PMC

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