Mistakes in intestinal failure and parenteral nutrition

Filters:

UEG Mistakes In Articles

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

Mistakes in intestinal failure and parenteral nutrition

Samreen Malik, Sarah Williams, Shameer Mehta

Summary

AI Generated

Parenteral nutrition is intravenous nutrient delivery used to treat intestinal failure when gut absorption is insufficient to maintain health.

The European Society for Clinical Nutrition and Metabolism classifies intestinal failure into acute type 1 and chronic types 2 and 3, with chronic cases often requiring long-term home parenteral nutrition.
Intestinal failure is rare but its prevalence in Europe is rising.
Parenteral nutrition formulations are complex and require skilled management by a specialized multi-disciplinary team to avoid complications.
This material is relevant for clinicians managing patients with intestinal failure or those involved in parenteral nutrition support teams.

Download PDF

Was this helpful?

Thanks for your feedback.

This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Parenteral nutrition (PN) is the intravenous delivery of nutrients, commonly used to treat intestinal failure (IF). IF occurs when gut function is insufficient to absorb macronutrients, water, or electrolytes, requiring IV supplementation to maintain health. The European Society for Clinical Nutrition and Metabolism (ESPEN) classifies IF into acute (type 1) and chronic (types 2 and 3), with chronic cases often needing long-term home parenteral nutrition (HPN). Although IF is rare, its prevalence in Europe is rising. PN formulations are complex, requiring skilled management by a specialized multi-disciplinary team to avoid complications.

Topics

Small Intestine & Nutrition

Citation

Williams S, Malik S and Mehta S. Mistakes in intestinal failure and parenteral nutrition and how to avoid them. UEG Education 2024; 24: 18-23.

Published

2024

More Like This:

Mistakes in Pancreatic exocrine insufficiency and how to avoid them

Matthias Löhr

MASLD with Sven Francque - Part 2

Pradeep Mundre

Mistakes in ostomy management and how to avoid them

Ian White

Mistakes in the management of peritoneal malignancies and how to avoid them

Charlotte Rabl

Mistakes in transjugular intrahepatic portosystemic shunt (TIPS) in cirrhosis and how to avoid them

Marco Senzolo

Mistakes in therapeutic drug monitoring of biologics in IBD and how to avoid them

Adam Cheifetz

UEG Mistakes In Articles

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

Mistakes in Pancreatic exocrine insufficiency and how to avoid them

Miroslav Vujasinovic, J. Enrique Domínguez Muñoz, Matthias Löhr

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Abstract

Pancreatic exocrine insufficiency (PEI) is a common yet frequently under-recognised cause of maldigestion, malabsorption, and malnutrition. Although traditionally associated with primary pancreatic disorders such as chronic pancreatitis, cystic fibrosis, pancreatic cancer, or pancreatic surgery, it is now evident that PEI also occurs in a wide range of extra-pancreatic conditions and clinical settings. Advances in diagnostic testing and expanding clinical awareness have improved detection; however, significant misconceptions persist regarding when to suspect PEI; how to interpret diagnostic tests; and how to initiate, optimise, and monitor pancreatic enzyme replacement therapy (PERT). In everyday practice, these errors may lead to delayed diagnosis, inappropriate treatment, persistent symptoms, and preventable nutritional deficiencies. This “Mistakes in…” article highlights common pitfalls in the diagnosis and management of PEI, focusing on inappropriate reliance on faecal elastase testing, failure to recognise secondary causes, undertreatment with PERT, and inadequate nutritional assessment. By addressing these frequent mistakes, we aim to promote a more structured, patient-centred, and evidence-informed approach to PEI that improves clinical outcomes and quality of life.

Topics

Pancreas

Published

2026

More Like This:

Mistakes in Pancreatic exocrine insufficiency and how to avoid them

Matthias Löhr

MASLD with Sven Francque - Part 2

Pradeep Mundre

Mistakes in ostomy management and how to avoid them

Ian White

Mistakes in the management of peritoneal malignancies and how to avoid them

Charlotte Rabl

Mistakes in transjugular intrahepatic portosystemic shunt (TIPS) in cirrhosis and how to avoid them

Marco Senzolo

Mistakes in therapeutic drug monitoring of biologics in IBD and how to avoid them

Adam Cheifetz

UEG Podcast Episode

UEG Podcast

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

MASLD with Sven Francque - Part 2

Sven Francque, Pradeep Mundre

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Abstract

Topics

Hepatobiliary

Published

2026

More Like This:

Mistakes in Pancreatic exocrine insufficiency and how to avoid them

Matthias Löhr

MASLD with Sven Francque - Part 2

Pradeep Mundre

Mistakes in ostomy management and how to avoid them

Ian White

Mistakes in the management of peritoneal malignancies and how to avoid them

Charlotte Rabl

Mistakes in transjugular intrahepatic portosystemic shunt (TIPS) in cirrhosis and how to avoid them

Marco Senzolo

Mistakes in therapeutic drug monitoring of biologics in IBD and how to avoid them

Adam Cheifetz

UEG Mistakes In Articles

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

Mistakes in ostomy management and how to avoid them

Revital Barkan, Ian White, Iris Dotan

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Abstract

Ostomy management refers to the care and maintenance of an ostomy and involves various aspects to ensure the individual’s health, comfort, and quality of life. This should involve the patient, a close support system (family and/or friends), and a healthcare team, including ostomy nurses and healthcare professionals specialising in ostomy care.

Topics

Primary Care

Published

2025

More Like This:

Mistakes in Pancreatic exocrine insufficiency and how to avoid them

Matthias Löhr

MASLD with Sven Francque - Part 2

Pradeep Mundre

Mistakes in ostomy management and how to avoid them

Ian White

Mistakes in the management of peritoneal malignancies and how to avoid them

Charlotte Rabl

Mistakes in transjugular intrahepatic portosystemic shunt (TIPS) in cirrhosis and how to avoid them

Marco Senzolo

Mistakes in therapeutic drug monitoring of biologics in IBD and how to avoid them

Adam Cheifetz

UEG Mistakes In Articles

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

Mistakes in the management of peritoneal malignancies and how to avoid them

Francesco Saverio Papadia, Matteo Santoliquido, Andrea Barberis, Tarkan Jäger, Charlotte Rabl

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Abstract

Peritoneal malignancies represent a complex and often misjudged clinical challenge. Historically synonymous with a terminal diagnosis, the advent of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) radically altered the prognosis for selected patients. However, progress has been jeopardised by a series of recurring and preventable errors in diagnosis, staging, and treatment selection. This article delineates the ten most critical pitfalls in managing peritoneal surface malignancies. For each pitfall, we provide evidence-based explanations, concrete clinical examples, and strategic recommendations for avoidance. We emphasise the pivotal role of early multidisciplinary discussion, precise imaging, and timely referral to high-volume expert centres to optimise patient outcomes and offer curative intent where previously there was none.

Topics

Digestive Oncology Surgery

Published

2026

More Like This:

Mistakes in Pancreatic exocrine insufficiency and how to avoid them

Matthias Löhr

MASLD with Sven Francque - Part 2

Pradeep Mundre

Mistakes in ostomy management and how to avoid them

Ian White

Mistakes in the management of peritoneal malignancies and how to avoid them

Charlotte Rabl

Mistakes in transjugular intrahepatic portosystemic shunt (TIPS) in cirrhosis and how to avoid them

Marco Senzolo

Mistakes in therapeutic drug monitoring of biologics in IBD and how to avoid them

Adam Cheifetz

UEG Mistakes In Articles

New

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

Mistakes in transjugular intrahepatic portosystemic shunt (TIPS) in cirrhosis and how to avoid them

Kymentie Ferdinande, Alberto Zanetto, Virginia Hernández-Gea, Marco Senzolo

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Abstract

TIPS success is rarely about the procedure alone. It depends on decisions made across the entire clinical pathway.

New in the UEG "Mistakes in…" series: Ferdinande et al., present 10 common mistakes in TIPS for cirrhosis, from referral to long-term follow-up.

Key themes:

• Screen the heart first: cardiac decompensation follows TIPS in up to 20% of patients.

• Refer early: delay costs survival in refractory ascites and high-risk variceal bleeding.

• Prevent encephalopathy by design: careful selection, nutrition, rifaximin, and controlled underdilation.

• Individualise haemodynamic targets and follow up structurally.

Topics

Hepatobiliary Surgery

Published

2026

More Like This:

Mistakes in Pancreatic exocrine insufficiency and how to avoid them

Matthias Löhr

MASLD with Sven Francque - Part 2

Pradeep Mundre

Mistakes in ostomy management and how to avoid them

Ian White

Mistakes in the management of peritoneal malignancies and how to avoid them

Charlotte Rabl

Mistakes in transjugular intrahepatic portosystemic shunt (TIPS) in cirrhosis and how to avoid them

Marco Senzolo

Mistakes in therapeutic drug monitoring of biologics in IBD and how to avoid them

Adam Cheifetz

UEG Mistakes In Articles

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

Mistakes in therapeutic drug monitoring of biologics in IBD and how to avoid them

Adam Cheifetz, Konstantinos Papamichail

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Abstract

Biological therapy has revolutionised the treatment of moderate to severe inflammatory bowel disease (IBD), namely Crohn’s disease (CD) and ulcerative colitis (UC). However, up to one-third of patients with IBD are primary non-responders, and up to half can lose response over time.These unwanted outcomes can be explained by either pharmacodynamic (mechanistic failure) or pharmacokinetic (PK) issues with or without the development of anti-drug antibodies (ADA), so-called immunogenicity.1 Reactive therapeutic drug monitoring (TDM), defined as the measurement of drug concentrations and anti-drug antibody (ADA) levels in the setting of primary non-response (PNR) or secondary loss of response (SLR), can help to explain better and manage these unwanted outcomes. However, it would make sense to try to prevent PNR and SLR by routinely measuring drug concentrations and ADA to achieve and maintain a targeted therapeutic drug concentration, the so-called proactive TDM. Here we discuss some common mistakes and significant errors to avoid when utilising TDM of biologics in patients with IBD. The discussion is based on evidence, whenever possible, and our clinical experience and perception of the field.

Topics

IBD

Citation

Konstantinos Papamichail and Adam S. Cheifetz. Mistakes in therapeutic drug monitoring of biologics in IBD and how to avoid them. UEG Education 2023; 23: 13-18.

Published

2023

More Like This:

Mistakes in Pancreatic exocrine insufficiency and how to avoid them

Matthias Löhr

MASLD with Sven Francque - Part 2

Pradeep Mundre

Mistakes in ostomy management and how to avoid them

Ian White

Mistakes in the management of peritoneal malignancies and how to avoid them

Charlotte Rabl

Mistakes in transjugular intrahepatic portosystemic shunt (TIPS) in cirrhosis and how to avoid them

Marco Senzolo

Mistakes in therapeutic drug monitoring of biologics in IBD and how to avoid them

Adam Cheifetz