Current management of bowel failure due to Crohn's disease in Spain: Results of the GETECCU survey

• Published in: Gastroenterología y Hepatología (English Edition) 2023-06, Vol.46 (6), p.439-445
• Main Authors: Suárez Ferrer, Cristina, Martín-Arranz, María Dolores, Martín-Arranz, Eduardo, Rodríguez Morata, Francisco, López García, Alicia, Benítez Cantero, Jose Manuel, Mesonero Gismero, Francisco, Barreiro-de Acosta, Manuel
• Format: Article
• Language: English
• Subjects: Crohn's disease; Enfermedad de Crohn; Fracaso intestinal; Intestinal failure; Teduglutida; Teduglutide
• ISSN: 2444-3824; 2444-3824
• DOI: 10.1016/j.gastre.2022.10.005

Intestinal failure is a rare pathology wich requires knowledge and highly specialised multidisciplinary management. Crohn's disease (CD) being one of the most frequent causes in adults. Survey format study carried out within the GETECCU group, included closed format questions about the diagnosis, management and current knowledge of intestinal failure in CD. 49 doctors participated, belonging to different Spanish centres (19 cities). It was considered that a patient suffered from intestinal failure, in 67.3% (33/49 surveyed) when there was a disorder malabsorptive associated regardless of the intestinal length resected, with surgeries resective ileal repeated (40.8%, 20/49), the most frequent cause. It highlights frequent ignorance about the pathology (24.5%) did not know if there were patients in their centre and also 40% did not know the pharmacological treatment. A total of 228 patients were registered for follow-up due to intestinal failure of any aetiology, 89 patients (39.5%) were identified with CD. Regarding the therapeutic management of patients with CD and intestinal failure (72.5%) were receiving total parenteral nutrition (NTP) and 24 patients (27%) with teduglitide. Regarding the response to the drug; 37.5% had no response to teduglutide, 37.5% partial response (reduce NTP) and 25% good response (withdrawal of home NTP). In questions related to knowledge about intestinal failure, it was considered limited (53.1%) or very limited (12.2%) by the surveyed. It is necessary to carry out a combined management of intestinal failure and CD in the context of a multidisciplinary approach. El fracaso intestinal es una patología poco frecuente en nuestro medio, pero que requiere de conocimientos y manejo multidisciplinar altamente especializado, siendo la enfermedad de Crohn una de las causas más frecuentes en el adulto. Estudio formato encuesta realizado en el seno de GETECCU, onsta de preguntas de formato cerrado sobre el diagnostico, manejo y conocimiento actual del fracaso intestinal en EC. Participaron 49 médicos, pertenecientes a distintos centros españoles (19 provincias). Se consideró que un paciente sufría un fracaso intestinal, en el 67,3% (33/49 encuestados) cuando existía un trastorno malabsortivo asociado independientemente de la longitud intestinal resecada, siendo las cirugías resectivas ileales repetidas (40,8%, 20/49), la causa más frecuente. Destaca frecuente desconocimiento sobre la patología: (24,5%) no sabían determinar si existían pac