Evidence map›Paper›PMID 42387900›Full record

ArticleJPEN. Journal of parenteral and enteral nutrition2026

Characterization of patients with medically unexplained intolerance to enteral feeding treated with home parenteral nutrition: A descriptive cohort study.

J W Korzilius, E J Limonard, A C Simon, F van der Heide, G Bouma, I Keuning, E T Grein, T J van den Heuvel, D Keszthelyi, G Dijkstra and 2 more

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Article in JPEN. Journal of parenteral and enteral nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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12 authors.

J W KorziliusDepartment of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands.ORCID https://orcid.org/0000-0002-6584-1172
E J LimonardDepartment of Endocrinology and Metabolism, Amsterdam University Medical Center, Amsterdam, The Netherlands.
A C SimonDepartment of Endocrinology and Metabolism, Amsterdam University Medical Center, Amsterdam, The Netherlands.
F van der HeideDepartment of Gastroenterology and Hepatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
G BoumaDepartment of Endocrinology and Metabolism, Amsterdam University Medical Center, Amsterdam, The Netherlands.
I KeuningDepartment of Psychiatry, Amsterdam University Medical Center, Amsterdam, The Netherlands.
E T GreinDepartment of Psychiatry, Amsterdam University Medical Center, Amsterdam, The Netherlands.
T J van den HeuvelDepartment of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands.
D KeszthelyiDepartment Gastroenterology and Hepatology, Maastricht University Medical Center, Maastricht, The Netherlands.
G DijkstraDepartment of Gastroenterology and Hepatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
M J SerlieDepartment of Endocrinology and Metabolism, Amsterdam University Medical Center, Amsterdam, The Netherlands.
G J A WantenDepartment of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands.

Funding

This research was not supported by grants from funding agencies in the public, commercial, or not-for-profit domains.
6 · The paper itself

Abstract

BACKGROUND AND

aimsDutch intestinal failure centers are increasingly confronted with patients started on total parenteral nutrition because of reported intolerance to enteral feeding without meeting clinical criteria for intestinal failure. This study aimed to describe clinical characteristics, medical consumption, and treatment status of patients with medically unexplained intolerance to enteral feeding treated with home parenteral nutrition.

methodsWe performed a descriptive cohort study in three intestinal failure expert centers in the Netherlands. We identified adult patients on total parenteral nutrition without a medical explanation for intolerance to enteral feeding via an electronic medical record search. We investigated patient characteristics, diagnostic procedures, and treatments these individuals had undergone. We also evaluated the impact of caring for these patients on physicians, using a questionnaire.

results78 patients on total parenteral nutrition and with medically unexplained intolerance to enteral feeding were analyzed. Most patients were female (91%), 80% were ≤45 years at the start of gastrointestinal complaints, 63% were on opioids, and in 83% discontinuation of total parenteral nutrition was not achieved. The impact on treating physicians was rated as at least very burdensome.

conclusionTreating patients with medically unexplained intolerance to enteral feeding with total parenteral nutrition is challenging for involved professionals in Dutch intestinal failure expert centers. This mainly concerns relatively young, female patients, most using opioids, and weaning off total parenteral nutrition is not successful in most cases. We suggest using caution when initiating total parenteral nutrition in patients with unexplained enteral intolerance before consultation with and/or assessment at an expert center.

Indexed as

Enteral NutritionIntestinal FailureParenteral Nutrition, HomeAdultAgedCohort StudiesFemaleHumansMaleMiddle AgedNetherlandsSurveys and Questionnairesdisorders of gut‐brain interactionfunctional gastrointestinal disordersintestinal failuretotal parenteral nutrition

Identifiers

PMID42387900
PMCPMC13636127

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