BACKGROUND:Aim was to investigate the association between quality of life (QoL), bowel anatomy, and the need for home parenteral support (HPS) volume in patients with nonmalignant short-bowel syndrome (SBS) and intestinal failure (IF). METHODS:The SBS-QoL scale was used in a cross-sectional study of 95 nonmalignant SBS-IF patients. Sum QoL scores (0: best, 170: worst) were calculated. Patients were defined as having a small bowel (≤200 cm), and patients with jejunostomy or ileostomy were subclassified based on functional small-bowel length (cm) into 4 anatomy subgroups: 1a-1d (0-49, 50-99, 100-149, 150-200 cm, respectively). Multiple linear regression analyses explored associations between QoL, patient groups, and HPS volume, adjusting for age, sex, body mass index, and education. RESULTS:Complete data were obtained from 60 patients. HPS volume was associated with a worse SBS-QoL score (L/d, β = 7.91; SE = 3.90; P = .048), but male sex associated with improvement (β = -26.28; SE = 11.06; P = .021). No differences in sum QoL were seen between the benign SBS-IF subgroups 1a-d (P = .210). Multivariate regression analyses showed that patients with a small-bowel stoma, a small-bowel length <50 cm was associated with a significantly worse/higher SBS-QoL score compared with a length >50 cm. CONCLUSION:In patients with benign SBS-IF, high HPS volume was associated with poor QoL. Also, jejunostomy or ileostomy with small-bowel length <50 cm was associated with impaired QoL. These findings support rehabilitation strategies that reduce fecal losses and decrease HPS needs.

Rationale: The aim was to investigate quality of life (QoL) associated to home parenteral support (HPS) volume and bowel-anatomy in short bowel syndrome (SBS) patients with intestinal failure (IF).

significantly prolonged at 7.19±1.69hours (p<0.005), the small bowel transit time (SBTT) was 4.86±0.21hours (hrs) (p<0.005), the colonic transit time (CTT) was significantly prolonged at 48.34±3.89hrs (p<0.005), and the whole gut transit time (WGTT) was significantly prolonged at 58.55±4.20 hrs (p<0.005)(Table ).Also, 26/91 (29.7%) of patients had delayed GET, as well as 22/91 (24.2%) with delayed SBTT and 28/91 (30.8%) with delayed CTT (Table ).Furthermore, in the subgroup of patient with delayed GET, 10/26 (38.4%) had slow SBTT, and 13/26 (50%) had slow CTT.CONCLUSIONS We found that approximately 30% of suspected gastroparetics had delayed GET, confirming gastroparesis, as well as delayed small bowel transit (24.2%), and delayed colonic transit (30.8%).This suggests that 1/3 rd of gastroparetics have a generalized dysmotility and slow-transit constipation, indicating that gastroparesis is a pan-enteric motility disorder.Significant new information regarding generalized dysmotility, with WMC testing, could pave the way for treatment of both upper and lower GI dysmotility in gastroparetics.Table .Comparison of Gut Transit Times (hours) *p<0.

enhanced microbial fermentation of dietary fiber and dysregulation of choline metabolism.The OPLS-DA model constructed based on samples collected post DI (R2X=30.7%,Q2Y= 0.37) showed higher concentrations of glutamate and 6-aminosalicylic acid in AA compared with AF.Microbial data acquired using HITChip was integrated with fecal profiles using OPLS.At the phylum level, 2 out of 22 identified phyla were significantly correlated with fecal profiles, which are Cyanobacteria and uncultured Mollicutes significantly correlating with fecal glutamate and valerate.By statistically integrating the fecal metabonome and the 130 microbial genus, Bacteroides vulgates et rel.and Bacteroides plebeius et rel.were observed to be correlated with choline, whereas Uncultured Clostridiales II was correlated with pyroglutamate.Uncultured Mollicutes, Eubacterium siraeum et rel and Aneurinibacillus demonstrated similar metabolic activity.Conclusions: These findings indicate that after only two-weeks of a dietary exchange diet, the fecal metabolic profile is significantly altered and that these metabolic changes are closely associated with alterations in the structure and function of the gut microbial network.

lead to a stabilisation or even an improvement of the bone mineral density (BMD) on the long range. Methods: Retrospective study of patients under HPN followed by the Gastroenterology Service of St-Luc Hospital from 2004 to 2011. Exclusion criteria were the lack of data on BMD or the absence of an osteodensitometry at the beginning of the HPN. Follow-up included regular visits with an endocrinologist, an initial dual energy X-ray absorptiometry at the start of HPN and every two years thereafter. BMD at the hip (g/cm2) were collected and their evolution was measured. A reduction or an increase in BMD was considered significant for a drop or a rise of 0.04 g/cm2 respectively. Results: 44 patients under HPN were identified. Data on BMD were collected for 30 individuals. A mean of 4 dual energy X-ray absorptiometry were performed for each patient. On average, we observed a drop of 0.01 g/cm2 (95% confidence interval (CI); drop of 0.03 rise of 0.01 g/cm2) in BMD for the entire follow-up. Globally, more than 70% of individuals showed a stabilisation or an increase in their BMD on the long range. It looks like there was no difference in the evolution of the bone status between people with osteoporosis initially and those without osteoporosis at the beginning of HPN. In addition, a small waiting time between the diagnosis of intestinal insufficiency and the beginning of HPN seems to ensure a better constancy of the BMD (odds ratio: 5.8; P value = 0.19). This trend seems similar when the duration of HPN was short (odds ratio: 4.5; P value = 0.16). Conclusion: An adequate follow-up of patients under HPN ensures a stabilisation of BMD on the long range.

First-trimester risk assessment for Down syndrome by maternal age, biochemistry and nuchal translucency scan has been offered to all pregnant women in Denmark since 2004. In this study we explored the quality of the informed choice for spontaneously pregnant women and their partners as well as for couples treated for infertility. Hereby it may be possible to evaluate the influence of the partner's knowledge and values on the pregnant woman's choice and we test our clinical hypothesis, that pregnant women treated for infertility have more knowledge about first-trimester risk assessment than spontaneously pregnant women. This prospective study used a questionnaire distributed in gestational week 12. The couples filled out the questionnaire separately just before the nuchal translucency scan. The questionnaire has been developed with the MMIC (Multidimensional Measurement of Informed Choice, developed and validated by Marteau) as a starting point. Participants were 327 spontaneously pregnant women (participation rate 95%), 261 partners (93%), 53 pregnant women treated for infertility (90%) and 46 of their partners (89%). The partners' answers did not differ significantly from the women's answers. All women knew that the risk assessment is specific for Down syndrome, and 85% had considered the possibility of having an induced abortion in case of Down syndrome. Most of the women underwent the risk calculation considering it as a positive thing, but even though 9% of the spontantaneously pregnant women considered screening negatively, they still chose to have a nuchal translucency scan. Overall knowledge of first-trimester risk assessment and its consequences was high, and did not differ between spontaneously pregnant women and women treated for infertility. Women as well as their partners seem well prepared to make decisions about screening in pregnancy. Data on and information from the pregnant women