| Title: |
Severe small bowel involvement and chronic intestinal pseudo-obstruction in systemic sclerosis (scleroderma): Pathophysiological, diagnostic and therapeutic basis, including parenteral nutrition ; Atteinte sévère de l’intestin grêle et pseudo-obstruction intestinale chronique au cours de la sclérodermie systémique : bases physiopathologiques, diagnostiques et thérapeutiques, dont la nutrition parentérale |
| Authors: |
Suzon, Benoît; Louis-Sidney, Fabienne; Abel, A.; Moinet, F.; Bagoée, Cécile; Henry, K.; Coco-Viloin, I.; Cougnaud, R.; Wolff, S.; Guilpain, Philippe; Rivière, Sophie; Flori, N.; Deligny, C.; Maria, A. |
| Contributors: |
Centre Hospitalier Universitaire de Martinique Fort-de-France, Martinique (CHU de Martinique); Épidémiologie Clinique et Vieillissement UR5_2 (EpiCliV); Université des Antilles (UA); Centre hospitalier territorial Gaston-Bourret Nouméa; Centre Hospitalier Andrée Rosemon Cayenne, Guyane Française; Groupe Hospitalier Paris Saint-Joseph (hpsj); Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP); Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB); Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM); Hôpital Saint Eloi CHU Montpellier; Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier); UNICANCER - Institut régional du Cancer Montpellier Val d'Aurelle (ICM); CRLCC Val d'Aurelle - Paul Lamarque |
| Source: |
ISSN: 0248-8663. |
| Publisher Information: |
CCSD; Elsevier |
| Publication Year: |
2024 |
| Collection: |
Université de Montpellier: HAL |
| Subject Terms: |
Systemic sclerosis; Prokinetics; Parenteral nutrition; Chronic intestinal pseudo-obstruction; Pseudo-obstruction intestinale chronique; Sclérodermie systémique; Prokinétiques; Nutrition parentérale; MESH: Humans; MESH: Intestinal Pseudo-Obstruction; MESH: Parenteral Nutrition; MESH: Intestine; Small; MESH: Scleroderma; Systemic; MESH: Risk Assessment; MESH: Chronic Disease; [SDV]Life Sciences [q-bio] |
| Description: |
International audience ; Gastrointestinal involvement in systemic sclerosis can be severe, reaching the critical point of chronic intestinal pseudo-obstruction, secondary to major disorders of small bowel motility. It is associated with some clinical and biological characteristics, in particular the positivity of anti-fibrillarin/U3RNP antibodies. Chronic intestinal pseudo-obstruction (CIPO) is complicated by a small intestinal bacterial overgrowth that requires cyclic antibiotic therapy. CIPO leads to a reduction of the food intake, due to painful symptoms, nausea and vomiting caused by meals, and ultimately to severe malnutrition. Meal splitting is often transiently effective and patients require exogenous nutritional support, mostly parenteral. Systemic sclerosis is not an obstacle to initiation and long-term continuation of parenteral nutrition and central venous catheter implantation is not associated with an increased risk of cutaneous or infectious complications. However, continuation of long-term parenteral nutrition requires monitoring in an expert nutrition center in order to adapt nutritional volumes and intakes and to limit potentially fatal cardiac and hepatobiliary complications. In addition to nutrition, prokinetic treatments, whose side effects must be known, can be associated. Invasive procedures, whose risk-benefit ratio must be carefully assessed, can also be used to treat symptoms exclusively. ; L’atteinte digestive au cours de la sclérodermie systémique peut être sévère et occasionner une véritable pseudo-obstruction intestinale chronique, secondaire à des troubles profonds de la motilité de l’intestin grêle. Elle est associée à certaines caractéristiques cliniques et biologiques, notamment la positivité des anticorps anti fibrillarine/U3RNP. La pseudo-obstruction intestinale chronique se complique d’une pullulation microbienne qui nécessite une antibiothérapie cyclique. Elle entraîne nécessairement une réduction du bol alimentaire compte-tenu des symptômes douloureux, nausées et ... |
| Document Type: |
article in journal/newspaper |
| Language: |
French |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/38388303; PUBMED: 38388303 |
| DOI: |
10.1016/j.revmed.2024.02.001 |
| Availability: |
https://hal.science/hal-04957460; https://doi.org/10.1016/j.revmed.2024.02.001 |
| Accession Number: |
edsbas.385FF093 |
| Database: |
BASE |