MARIANA HOLLANDA MARTINS DA ROCHA

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2
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Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico

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  • article 5 Citação(ões) na Scopus
    Treating short bowel syndrome with pharmacotherapy
    (2020) ROCHA, Mariana Hollanda Martins Da; LEE, Andre Dong Won; MARIN, Marcia Lucia De Mario; FAINTUCH, Salomao; MISHALY, Asher; FAINTUCH, Joel
    Introduction: Short bowel syndrome (SBS) has traditionally been regarded as a rapidly fatal medical catastrophe. The advent of pharmacological options directly targeting disease pathophysiology justified this review. Areas covered: Since the 1970s, home parenteral nutrition has reduced mortality, converting SBS into a chronic and disabling compensated and occasionally curable illness. Off-label antidiarrheal drugs and related products, though having minimal scientific evidence of efficacy, represent the standard-of-care and are here reviewed. Trophic intestinal hormones, including GLP-2 and its analogs, have great promise for alleviating malabsorption, the most important symptom within a nonsurgical, routine outpatient framework. Current indications involve adults with massive intestinal losses (fecal wet weight >1500 g/day). Surgical options such as intestinal lengthening or transplantation are also addressed although these options are considerably more aggressive and have stricter indications. Expert opinion: GLP-2 analogs are the first candidates from a pioneering pharmacotherapic family within the SBS framework, namely disease-modifying, absorption-restoring agents. This family of drugs, potentially applicable in all contexts of severe intestinal loss, could become the therapeutic benchmark of the near future.