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

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

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.

MeSH terms

  • Adult
  • Chronic Disease
  • Crohn Disease* / complications
  • Crohn Disease* / drug therapy
  • Crohn Disease* / epidemiology
  • Crohn Disease* / therapy
  • Cross-Sectional Studies
  • Female
  • Gastrointestinal Agents / therapeutic use
  • Humans
  • Intestinal Diseases / epidemiology
  • Intestinal Diseases / therapy
  • Intestine, Small
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Peptides / therapeutic use
  • Prevalence
  • Short Bowel Syndrome* / complications
  • Short Bowel Syndrome* / epidemiology
  • Short Bowel Syndrome* / therapy
  • Surveys and Questionnaires

Substances

  • teduglutide
  • Peptides
  • Gastrointestinal Agents

Grants and funding

This study was partially funded by the Italian Ministry of Health, current research IRCCS.