Department of Pathophysiology and Transplantation, Università degli Studi di Milano, 20122 Milan, Italy.
OU Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
Nutrients. 2024 Sep 30;16(19):3311. doi: 10.3390/nu16193311.
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.
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.
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%], = 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.
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.
背景/目的：关于克罗恩病（CD）中短肠综合征（SBS）和慢性肠衰竭（CIF）的流行病学和临床管理，数据有限。本研究旨在评估意大利的这些方面。
意大利炎症性肠病研究组（IG-IBD）的成员被邀请完成一项横断面网络调查。亚组分析考察了不同临床环境对 CD 中 SBS 和 CIF 管理的影响。
共有 128 个 IG-IBD 中心中的 47 个（36.7%）参与了调查。其中，31.9%为特杜鲁肽（TED）处方者，48.9%为学术中心。小肠 CD 患者中 CIF 的估计患病率为 1%，在学术中心中显著更高（2.0%[IQR 1-5%]比 0.13%[IQR 0-1%]，=0.02）。78%的中心管理的 SBS 和 CD 患者少于 10 例。仅 15%和 42.6%的中心分别常规进行小肠测量和营养评估。12 个中心为 35 名患者开具了 TED，81.8%的中心治疗成功率超过 50%。
意大利小肠受累 CD 患者中 CIF 的估计患病率为 1%。SBS 和 CIF 的诊断和管理实践并不理想，TED 的使用有限。
