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Clinicians
should pay attention to predictors that may increase the risk for short bowel
syndrome in Crohn’s disease patients.
A recent study revealed three vital predictors influencing the occurrence of short bowel syndrome in patients suffering from Crohn's disease: (a) Montreal B1 behavior at diagnosis, (b) intravenous steroids use, and (c) budesonide use.
A retrospective case-control single-center study was conducted to explore independent predictors for short bowel syndrome in Crohn's disease patients to allow the development of best therapeutic management and lower surgery rate.
The study recruited adult patients (older than 18 years) visiting the hospital for Crohn's disease or short bowel syndrome between 2012 and 2019. Overall, 410 Crohn's disease patients were included (369 without short bowel syndrome, 41 with short bowel syndrome). Each Crohn's disease patient with short bowel syndrome was matched to nine controls.
Subjects suffering from short bowel syndrome reported a remarkably higher number of bowel resections compared to the control group. The median time before the first surgery was not different compared to the control group, as shown in the table below:
A raised requirement for parenteral support was witnessed in patients with end-jejunostomy short bowel syndrome compared to patients with jejunocolic and jejunoileal short bowel syndrome (70.6% vs 25% and 0%). Montreal B1 behavior and budesonide treated-patients were at minimized risk of short bowel syndrome, while intravenous steroid treated-patients were at an elevated risk.
Thus, to prevent the onset of short bowel syndrome in Crohn’s disease patients, evaluation of the risk predictors should be done in daily clinical practice. Further studies should focus on assessing whether treatment with biologics can be a viable alternative to steroids to minimize the risk of short bowel syndrome.
Digestive and Liver Disease
Predictors for short bowel syndrome in Crohn’s disease
Simon Vaillant et al.
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