Reducing Dependence on Parenteral Support (PS)
is an Important Goal for SBS Patients1

Patients often require PS to make up for reduced absorption. Reducing or eliminating PS are important treatment goals for any patient with SBS. Establishing these goals will require a discussion of symptoms management, treatment expectations, and diet/lifestyle modifications.1

PS can be intravenous fluids and/or nutrition. It can be lifesaving for patients with SBS; however, long-term use of PS may lead to other complications such as2-4*:

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Hepatobiliary
Diseases ie, intestinal failure–associated liver disease [IFALD] and gallstones

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Kidney
Diseases ie, hyperoxaluria

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Central Venous
Complications ie, septic infections, thrombosis, and loss of vascular access

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Metabolic
Bone Disease ie, osteoporosis

A reduction in PS requirements may give patients more freedom for work, hobbies, school, sleep, rest, and social interaction.5,6†

*The effects of GATTEX on these complications were not studied.

†Examples of how some patients may spend their time if they are able to achieve a reduction in PS requirements are for illustrative purposes only. Patients should always discuss their individual medical circumstances and activities with their doctor.

Patient characteristics that can positively impact a PS weaning plan

Characteristic Influence on weaning success

Length of remnant bowel

 The length of remnant bowel is important and can increase chances of weaning success1,7

Presence of a colon

 Provides better chance of PS weaning by facilitating fluid and energy absorption1

Presence of ileum/ileocecal valve

 Slows small bowel transit time and may reduce reflux of colonic bacteria into the small intestine1

Sufficient bowel adaption

 Increases absorption and extends intestinal transit time1,7

Absence of underlying pathology/disease

 Patients free of underlying conditions (ie, Crohn’s disease, radiation enteritis, carcinoma) generally experience more complete PS weaning1

Compliance

 Patients’ compliance with all therapies (diet, oral rehydration solutions [ORS], antidiarrheal, other medications) can impact weaning success1

Oral intake

 The ability to tolerate oral intake can be a factor in facilitating the PS weaning process1

Weaning PS Is a Multistep Process8

Prepare a personalized PS weaning plan with your patients

Develop the weaning plan based on patient characteristics as well as patients’ treatment goals2,8

Patients with SBS-IF differ in age and pathophysiology as well as in duration of PS and nutritional status. These and other factors can impact weaning.2,8

Multidisciplinary care may improve outcomes in weaning PS8,9

Engaging a team across disciplines can improve outcomes, reduce complications, and give patients the support they need when trying to achieve enteral autonomy.

  • Surgeon
  • Gastroenterologist
  • Dietitian
  • Pharmacist
  • Primary care physician
  • Advanced practice provider
  • Social worker
  • Home care company
  • Specialty pharmacist
  • Ostomy nurse
Icons and background images are purely decorative elements and do not convey additional meaning, content, or information to users who rely on screen readers. As such, they do not require alt text for accessibility purposes.
Icons and background images are purely decorative elements and do not convey additional meaning, content, or information to users who rely on screen readers. As such, they do not require alt text for accessibility purposes.

A stepwise, personalized weaning plan should accommodate the patient’s unique needs8

Depending on patient characteristics, eliminating PS requirements may not be possible—but patients may still achieve meaningful reductions in PS volume and time, with fewer hours/days on PS10

Clearly defined care protocols should be established for situations such as dehydration or nutritional instability that may require IV fluids or vitamin/mineral/electrolyte supplements and diet adjustment8,10

Patients should have a good understanding of who is part of their multidisciplinary team, their contact information, and how each of them will help during the weaning process8,9,11

Patients need to remain consistent with all therapies (modified diet, ORS, medications, vitamin/mineral/electrolyte supplements, and use of PS and adherence to PS reductions as directed)8

Water is not recommended for most patients with SBS-IF10

Puzzle Icon

Homemade oral rehydration solution12

  • 1 quart of ready-to-drink Gatorade® G2 Low Calorie*
  • 1/2 teaspoon salt

Directions: Add salt to ready-to-drink Gatorade G2 and shake well.

Note: Potassium levels in this recipe are well below the recommended amount for an ORS.

*Gatorade® is a registered trademark of PepsiCo.

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