Use and Misuse of Parenteral Nutrition in Patients with Inflammatory Bowel Disease

Inflamm Bowel Dis. 2022 Oct 3;28(10):1592-1602. doi: 10.1093/ibd/izac085.

Abstract

Malnutrition is a very common and often underrecognized condition among patients with inflammatory bowel diseases (IBD). This is most commonly due to increased nutritional requirements and gastrointestinal losses, along with reduced oral intake. Screening for malnutrition is an essential component of managing both inpatients and outpatients with IBD. Although enteral nutrition is the preferred route of supplementation, parenteral nutrition (PN) remains an important strategy and should be considered in certain situations, such as cases with short-bowel syndrome, high-output intestinal fistula, prolonged ileus, or small-bowel obstruction. Appropriate use of PN is critical in order to prevent associated complications. This review addresses the common indications for use of PN, the composition of PN, and the possible complications encountered with PN use, as well as scenarios of inappropriate PN use among patients with IBD. A clinical management algorithm for utilizing PN among patients with IBD is proposed in this review.

Keywords: EN; IBD; TPN; inflammatory bowel disease; malnutrition; parenteral nutrition.

Plain language summary

Malnutrition is common and underrecognized among patients with inflammatory bowel diseases (IBD). Screening for malnutrition is an essential component of IBD management. Although enteral nutrition is the preferred route of supplementation, parenteral nutrition (PN) should be considered in certain situations. Appropriate use of PN is critical to prevent associated complications.

Publication types

  • Review

MeSH terms

  • Chronic Disease
  • Enteral Nutrition
  • Humans
  • Inflammatory Bowel Diseases* / complications
  • Inflammatory Bowel Diseases* / therapy
  • Malnutrition* / etiology
  • Malnutrition* / prevention & control
  • Parenteral Nutrition / adverse effects
  • Short Bowel Syndrome* / complications
  • Short Bowel Syndrome* / therapy