Pharmacotherapy in the Management of Intestinal Failure: An Updated Review of Current Therapies and Beyond

Intestinal failure (IF), a rare organic dysfunction, is characterized by a reduction in intestinal function, necessitating intravenous supplementation to sustain health and/or growth due to inadequate absorption of macro and micronutrients, water, and electrolytes. This condition is distinct from "Intestinal Insufficiency," where intravenous replacement is not immediately necessary. The purpose of this review is to evaluate the literature published in the last 5 years on drug treatment in the management of patients with intestinal failure (IF) and short bowel syndrome (SBS) and to identify strategies to minimize fluid and electrolyte loss by increasing nutrient-enterocyte contact time, improving intestinal transit time, replenishing micronutrients, and enhancing nutrient absorption.

We describe current treatments for rehabilitation aimed at optimizing absorption of the intestinal mucosa. We also outline recommended pharmacological adjustments of some drugs used in the treatment of commonly found comorbidities in these patients. Recent articles have demonstrated that GLP-2 analogs have become an important tool in the treatment of SBS, improving intestinal secretory control, gastrointestinal transit time, nutrient absorption, and, most importantly, positively impacting quality of life.

IF is a rare disease defined by need for intravenous hydration and nutrients delivery and associated with malnutrition and high mortality rate. Medical management and treatment of IF can increase survival time and quality of life.