医学
肠外营养
营养不良
硬皮病(真菌)
肠内给药
重症监护医学
疾病
内科学
病理生理学
胃肠道疾病
胃肠病学
免疫学
接种
作者
Shishira Bharadwaj,Parul Tandon,Tushar Gohel,Mandy L. Corrigan,Kathleen Logan Coughlin,Abdullah Shatnawei,Soumya Chatterjee,Donald F. Kirby
标识
DOI:10.1097/mcg.0000000000000334
摘要
Scleroderma (systemic sclerosis) is an autoimmune disease that can affect multiple organ systems. Gastrointestinal (GI) involvement is the most common organ system involved in scleroderma. Complications of GI involvement including gastroesophageal reflux disease, small intestinal bacterial overgrowth, and chronic intestinal pseudoobstruction secondary to extensive fibrosis may lead to nutritional deficiencies in these patients. Here, we discuss pathophysiology, progression of GI manifestations, and malnutrition secondary to scleroderma, and the use of enteral and parenteral nutrition to reverse severe nutritional deficiencies. Increased mortality in patients with concurrent malnutrition in systemic sclerosis, as well as the refractory nature of this malnutrition to pharmacologic therapies compels clinicians to provide novel and more invasive interventions in reversing these nutritional deficiencies. Enteral and parenteral nutrition have important implications for patients who are severely malnourished or have compromised GI function as they are relatively safe and have substantial retrospective evidence of success. Increased awareness of these therapeutic options is important when treating scleroderma-associated malnutrition.
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