Managing Fluid Balance and Nutritional Status in a Short Bowel Syndrome Patient awaiting Intestinal Transplant: A Case Report.

In this report, we present a case of an SBS patient with only 5 cm of remaining small bowel and a high-output duodenal stoma, who was treated with teduglutide resulting in a reduction of stoma output, improvement in the patient's nutritional status and regulation of fluid balance.
Managing Fluid Balance and Nutritional Status in a Short Bowel Syndrome Patient awaiting Intestinal Transplant: A Case Report.
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Short bowel syndrome (SBS) poses significant challenges, particularly when surgical resection leaves patients with less than 200 cm of small bowel. In such cases, the initiation of teduglutide injections, a synthetic analogue of glucagon-like peptide-2, has emerged as a promising therapy. Teduglutide regulates gastrointestinal tract growth, enhances nutrient absorption, and reduces the need for parenteral support.

In a compelling case report, a 53-year-old female with severe malnutrition and a high-output duodenal stoma experienced a remarkable transformation with teduglutide treatment. Despite having only 5 cm of remaining small bowel, the patient's stoma output reduced from 6-12 L/day to 2.5-3 L/day within two months of teduglutide initiation. This not only stabilized electrolyte balance but also led to a notable 3-4 kg increase in body weight.

The case sheds light on teduglutide's effectiveness in managing high output stomas, even in patients with minimal small bowel. Notably, the therapy provided a breakthrough, allowing the patient to achieve energy and protein targets without compromising fluid balance. While the report acknowledges the need for further studies and consistent dosing, it underscores teduglutide's potential as a long-term treatment for SBS patients dependent on parenteral nutrition.

In conclusion, teduglutide represents a beacon of hope for individuals facing the challenges of SBS, offering a path to improved nutritional status and a reduced reliance on parenteral support. Further research is warranted to solidify its standing as a groundbreaking therapy for high output stomas in SBS patients.

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