Patients with hypermobility disorders on intestinal failure units - A multi-centre UK survey
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Authors
Lam C.
Paine P.
Mooney P.
Gabe S.
Lal S.
Mcalindon M.
Fikree A.
Hollingworth T.
Smith T.
ZarateLopez N.
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2025
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Article
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Rationale: Patients with hypermobility disorders (HD) increasingly present to intestinal failure units (IFUs) for parenteral nutrition (PN) without intestinal failure (1). Aim(s): Describe indications, complications, comorbidities and medication in this population. Method(s): Questionnaire of anonymised retrospective data from 2012 to 2022 from 7 UK HPN centres. Result(s): 84 patients (82 female) were included, mean age 35 (range 18-70). 56% remain on PN. [Formula presented] Comorbidities: POTS 65%; MCAS 15%; constipation 33%; eating disorder 8%; fibromyalgia 8% functional neurological disorder 9%; gastroparesis 27%; bladder pathology 21%; osteoporosis 13%; migraine 12%; chronic pain 14%; depression 11%; CIPO 5%; rectal prolapse 2%, anxiety 5%. Total number of admissions was 370 (7943 inpatient bed days). Mean length of stay was 21 days, median 11 days, range 1-386, due to catheter related blood steam infections (CRBSI)102, line complications 32, exit site infection 5, enteral tube complication 8 and tube site infection 5. 79% were on opioids and 21% on parenteral cyclizine. Conclusion(s): Initiation of CANH in patients with HD differs to usual practice (2). CRBSI rates are higher than usual at 12.84/1000 inpatient bed days (3). High rates of opioid and parenteral cyclizine use seen. The escalating provision of CANH in patients with HD exposes patients to considerable unwarranted harm given increased complications and atypical indications. Robust evaluation of the indication for provision of CANH is recommended. References: 1. Vasant DH et al 2020 doi: 10.1111/nmo.13937 2. Lal S et al doi: 10.1111/nmo.14853. 3. Bond A et al doi: 10.1136/flgastro-2018-101094. Disclosure of Interest: None declared Copyright © 2025
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Clin.Nutr.ESPEN
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North American Neuromodulation Society 28th Annual Meeting.