Total Parenteral Nutrition and Inflammatory Bowel Disease: Indications, Long term Outcomes, and Complications

Intestinal failure is associated with the inability to maintain protein, energy, electrolyte, fluid, or micronutrients balance while receiving a conventional diet. Subsets of inflammatory bowel disease (IBD) patients require total parenteral nutrition (TPN) as a result of extensive small bowel damage, obstruction, or resection that prevents adequate enteral nutrition. In these patients, TPN represents an essential modality to hasten further nutritional deficiency, restore nutritional homeostasis, and prevent long term complications of nutritional deficiency. Specific indications for TPN in IBD include supportive therapy, life sustaining therapy, volume and calorie replacement, perioperative nutritional support, and gut rest. Patients being treated with TPN have been shown to benefit the most from a home parenteral nutrition treatment plan due to its success in avoiding hospitalization and associated costs.