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Intestinal failure in children and young people with neurodisabling conditions
  1. Amar M Wahid1,
  2. Colin V Powell2,3,
  3. Ieuan H Davies4,
  4. Jennifer A Evans5,
  5. Huw R Jenkins4
  1. 1Department of Paediatric Gastroenterology, University Hospital of Wales, Cardiff, UK
  2. 2Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
  3. 3Department of General Paediatrics, Noah's Ark Children's Hospital for Wales, Cardiff, UK
  4. 4Department of Paediatric Gastroenterology, Noah's Ark Children's Hospital for Wales, Cardiff, UK
  5. 5Department of Paediatrics, Noah's Ark Children's Hospital for Wales, Cardiff, UK
  1. Correspondence to Dr Amar M Wahid, Department of Gastroenterology and Nutrition, Birmingham Children's Hospital, Steelhouse Lane, Birmingham B4 6NH, UK; amarwahid{at}doctors.org.uk

Abstract

Gastrointestinal dysmotility is common in children and young people with neurodisabling conditions. In this article we seek to highlight the increasing difficulties faced by paediatricians in managing intestinal failure in this patient group. It is becoming clear that, as the median age for survival increases, intestinal failure is a significant problem, and can in some cases become life-limiting. The ethical issues around starting children with life-limiting conditions on parenteral nutrition (PN) are extremely complicated, not least because we are ignorant of the mechanism of intestinal failure in these children, and indeed, which of these children might be able to return to enteral feeding after a period of PN. Our article highlights these issues, drawing on our experience of a particularly difficult case, which we hope will stimulate further discussion among paediatricians providing care for children with neurodisabling conditions.

  • Intestinal failure
  • Neurodisability
  • Parenteral nutrition
  • Dysmotility

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Footnotes

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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