Rehabilitation of patients with gastrointestinal failure

Abstract

Background - Patients with gastrointestinal (GI) failure have a prolonged or permanent inability to ingest, digest and/or absorb adequate fluid and nutrients to prevent dehydration, progressive malnutrition and the wasting of body protein. This loss of body protein is associated with immunosuppression, respiratory and skeletal muscle weakness which contribute further to the patients' debility. Although standard methods of enteral and total parenteral nutrition (TIN) are required to sustain life, they remain supportive therapies which are relatively ineffective at repleting body protein or enhancing the function of the diseased or resected intestinal tract, thus, often failing to contribute to the rehabilitation of the patient. Because specific growth factors (e.g. growth hormone - GH) and nutrients (e.g. glutamine - GLN) can produce anabolic effects on body composition, induce trophic effects on the gastrointestinal tract and influence bowel function, 3 studies were conducted to determine if such substances could accelerate protein accrual, enhance nutrient absorption and reduce or eliminate long-term dependence upon specialized findings. [TRUNCATED]