Journal
CLINICS IN LIVER DISEASE
Volume 23, Issue 2, Pages 279-+Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.cld.2018.12.009
Keywords
Liver disease; Steatosis; Cholestasis; Intestinal failure; Short bowel syndrome; Parenteral nutrition; Lipid emulsion
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Intestinal failure-associated liver disease (IFALD) is characterized by either liver steatosis or cholestasis and may develop in patients on long-term home parenteral nutrition for chronic intestinal failure. The pathogenesis of IFALD is multifactorial and includes gastrointestinal disease-related, parenteral nutrition-related, and systemic-related factors. Alteration of bile acid enterohepatic circulation, gut microbiome, and intestinal permeability, seem to be the main mechanisms. Patients forced to a total oral fasting regimen are at greater risk. Parenteral nutrition overfeeding and/or of soybean-based lipid emulsion may be contributing factors. Prevention and treatment are based on avoiding and promptly treating all the risk factors.
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