ESPEN 2022 Late Breaking Abstracts

Topic: Nutrition and chronic disease

Abstract Submission Identifier: ESPEN22-LB-2183

TEDUGLUTIDE THERAPY OPTIMIZATION THROUGH CONTINUOUS ORAL NUTRITION COUNSELLING IN CHRONIC INTESTINAL FAILURE PATIENTS

U.-F. Pape ¹, E. Blüthner ², D. Thurmann ², J. Büttner ², F. Tacke ², S. Maasberg ¹, S. Pevny^*, ²

¹Innere Medizin und Gastroenterologie, Asklepios Klinik St. Georg, Hamburg, ²Department of Hepatology and Gastroenterology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany

Rationale: Teduglutide (TED) is a medical treatment for patients with chronic intestinal failure (cIF) aiming to reduce parenteral support (PS). We present here clinical case experiences, in which oral nutrition plays a major role for therapy effect.

Methods: Retrospective medical records review of TED-treated cIF patients.

Results: Four patients were identified (A-D) with a median follow up of 5 years [min 2.5; max: 7.6]. Patient A’s cIF onset was in early childhood, requiring daily PS. Seven weeks after TED initiation, she responded with 30% volume and 20% calorie PS reduction. Repeated nutrition counselling revealed that she has never learned to eat regularly per os and did not follow hyperphagia advice. Finally, oral intake was increased including oral nutrition supplement drinks, which resulted in PS 4x/week (-57% volume; -41% calorie) after 3 years of TED treatment. Patient B showed a 20% volume reduction after 4 months. The following 2.5 years were characterized by weight fluctuations due to insufficient oral intake of food and drinks because she mentally did not tolerate high stoma output. Despite repeated consultations, she did not adhere to oral intake advice. TED was stopped temporarily. Patient C was weaned from calories after 37 weeks. After 44 weeks, he increased physical activity and workload. Body weight dropped slightly, but stabilized with additional protein and maltodextrin powder, and oral nutrition supplement drinks. Patient D was weaned from calories after 26 weeks. After 48 weeks, she suffered from port infection and pylorus stenosis, resulting in weight loss (BMI 25.2 to 22.8 kg/m²). Oral diet optimization with baby porridge restored body weight after 2 years of TED treatment.

Conclusion: Conclusion: Oral nutrition in TED treated cIF patients has to be tailored to individual requirements and should be reevaluated continuously during treatment, which is necessary in order to achieve maximal therapeutic effect of resource intense TED treatment.

References:  -

Disclosure of Interest: None Declared

Keywords: None