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Best Pract Res Clin Gastroenterol. 2003 Dec;17(6):907-29.

Hepatobiliary, renal and bone complications of intestinal failure.

Author information

1
Digestive Disease Centre, Leicester Royal Infirmary, Windsor Building, Leicester, LE1 5WW, UK. jeremy.nightingale@uhl-tr.nhs.uk

Abstract

Abnormal liver function tests in patients with intestinal failure (IF) may be due to the underlying disease, IF or the treatments given (including parenteral nutrition (PN)). PN-related liver disease in children usually relates to intrahepatic cholestasis and in adults to steatosis. Steatosis may be consequent upon an excess of carbohydrate, lipid or protein, or upon a deficiency of a specific molecule. Pigment-type gallstones are common in adults and children with IF; these develop from biliary sludge that forms during periods of gallbladder stasis. Ileal disease/resection, parenteral nutrition, surgery, rapid weight loss and drugs all increase the risk of developing gallstones. Gallstone formation may be prevented by reducing gallbladder stasis (oral/enteral feeding or prokinetic agents), altering bile composition, or by means of a prophylactic cholecystectomy. Calcium oxalate renal stones are common in patients with a short bowel and retained functioning colon and are consequent upon increased absorption of dietary oxalate; they are prevented by a low-oxalate diet. An osteopathy may occur with long-term parenteral nutrition.

PMID:
14642857
DOI:
10.1016/s1521-6918(03)00108-2
[Indexed for MEDLINE]

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