Nutritional and pharmacotherapeutical aspects in intestinal failure

Chronic intestinal failure (CIF) is a rare disease with an estimated prevalence in Europe of 5-80 per million people. IF can be classified in three categories, depending on the expected duration of the disease: acute (type I), prolonged acute (type II) or chronic (type III) IF. IF can also be classified into five categories based on the pathophysiology: short bowel, intestinal fistula, extensive small bowel mucosal disease, intestinal dysmotility and mechanical obstruction. Several gaps in research in IF were discussed in the ESPEN (European Society for Clinical Nutrition and Metabolism) recommendations of 2019. This PhD will focus on different nutritional and pharmacotherapeutic aspects in IF patients. First, a prospective interventional study will be initiated to study the effect of an electronic tool to optimise the initiation of PN therapy in hospitalised patients. Second, a practical guideline including a prescribing algorithm on which aspects to consider when initiating drugs in patients with short bowel syndrome (SBS), will be developed. Third, the pharmacokinetic properties of the anticoagulant apixaban in SBS patients on long-term parenteral nutrition will be investigated. Finally, current evidence and clinical practice on how to manage acute mesenteric ischaemia will be identified.