L cells are enteroendocrine cells that are generally located in the small intestine and colon.
GLP-2 is secreted by L cells in the intestine.

anastomosis24

anastomosis24

jejunostomy24
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MALNUTRITION
DEHYDRATION
ELECTROLYTE
DISTURBANCES
DIARRHEA / INCREASED
OUTPUTS
Patients with SBS are heterogeneous because of large variations in intestinal function and remnant bowel anatomy.5
Factors such as parenteral support (PS) dependency, age, primary disease process, and comorbidities can affect the overall prognosis in patients—including survival rates and life expectancy, which can vary.6,7
SBS is a condition characterized by a collection of clinical features, not only length of remaining bowel.5
*Patients with SBS require varying fluid/nutritional interventions based on individual needs.
“ Finding something that works for you might take time and effort, but in the end, it's worth it.”
This is not a complete list of causes for SBS.
ADULT PATIENTS8-11
PEDIATRIC PATIENTS12,13
Patients with SBS may go undiagnosed due to underreporting and the lack of reliable patient databases.14
For more information on how SBS patients may present, explore different patient profiles for adult patients and a pediatric patient.
While there is no cure for SBS, a multidisciplinary team can help manage it. Experts can include physicians, surgeons, nurses, dietitians, and/or social workers who may contribute to the success of achieving patients' treatment goals.15
PS dependency can vary in nutritional components, frequency, and administration times.4
Delivers hydration along with electrolytes and potentially other components (ie, dextrose 5% and 0.45%, normal saline, lactated ringer’s).
Provides balanced caloric energy needs and can include a variety of components, such as protein, fat, and sugar, as well as electrolytes and vitamins.
Hepatobiliary diseases (ie, intestinal failure-associated liver disease [IFALD] and gallstones)
Kidney diseases (ie, hyperoxaluria)
Metabolic bone diseases (ie, osteoporosis)
Central venous complications (ie, septic infections, thrombosis, and loss of vascular access)
§Examples of how some patients may spend their time if they are able to achieve a reduction in PS requirements are for illustrative purposes only.
Patients should always discuss their individual medical circumstances and activities with their doctor.
GLP-2 is a naturally occurring hormone that plays a role in maintaining the structure and function of the intestine to facilitate absorption.31-33¶
Increase villus height and crypt depth29,30
Facilitate absorption of nutrients26-30
Increase intestinal and portal blood flow34,35
Inhibit gastric acid secretion30,34,36
¶Based on studies in animals and healthy volunteers; the clinical relevance of these data has not been established.
Any resection can impact GLP-2 secretion resulting in SBS#
L cells are enteroendocrine cells that are generally located in the small intestine and colon.
GLP-2 is secreted by L cells in the intestine.
#This is not a comprehensive list of bowel resections.
Images are for illustrative purposes only. GLP-2 secretion after resection will vary, and different anatomies may lead to SBS.
GATTEX® (teduglutide) for injection is indicated for the treatment of adults and pediatric patients 1 year of age and older with short bowel syndrome (SBS) who are dependent on parenteral support.
Warnings and Precautions
GATTEX has been associated with acceleration of neoplastic growth, intestinal obstruction, biliary and pancreatic disease, fluid imbalance and fluid overload, and increased absorption of concomitant oral medication. Click here for additional Safety Information.
INDICATION
GATTEX® (teduglutide) for injection is indicated
for the treatment of adults and pediatric patients 1 year of age and older with short bowel syndrome (SBS) who
are dependent on parenteral support.
IMPORTANT SAFETY INFORMATION
Warnings and Precautions
Acceleration of neoplastic growth
Colorectal polyps were identified during
clinical trials. There is a risk for acceleration of neoplastic growth. In adults, within 6 months prior to
starting treatment with GATTEX, colonoscopy of the entire colon with removal of polyps should be performed and
follow-up colonoscopy (or alternate imaging) is recommended at the end of 1 year of GATTEX. Subsequent
colonoscopies should be performed every 5 years or more often as needed.
In children and adolescents, perform fecal occult blood testing prior to initiating treatment with GATTEX. Colonoscopy/sigmoidoscopy is required if there is unexplained blood in the stool. Perform subsequent fecal occult blood testing annually in children and adolescents while they are receiving GATTEX. Colonoscopy/sigmoidoscopy is recommended for all children and adolescents after 1 year of treatment, every 5 years thereafter while on continuous treatment with GATTEX, and if they have new or unexplained gastrointestinal bleeding.
In case of intestinal malignancy (GI tract, hepatobiliary, pancreatic), discontinue GATTEX. The clinical decision to continue GATTEX in patients with non-gastrointestinal malignancy should be made based on benefit-risk considerations.
Intestinal obstruction
Intestinal obstruction has been reported in clinical trials
and postmarketing. In patients who develop intestinal or stomal obstruction, GATTEX should be temporarily
discontinued pending further clinical evaluation and management.
Biliary and pancreatic disease
Cholecystitis, cholangitis, cholelithiasis, and
pancreatitis have been reported in clinical trials and postmarketing. Laboratory assessment (bilirubin,
alkaline phosphatase, lipase, amylase) should be obtained within 6 months prior to starting GATTEX. Subsequent
laboratory tests should be done every 6 months or more often as needed. If clinically meaningful changes are
seen, further evaluation is recommended including imaging, and continued treatment with GATTEX should be
reassessed.
Fluid imbalance and fluid overload
Fluid overload and congestive heart failure
have been observed in clinical trials. If fluid overload occurs, especially in patients with underlying
cardiovascular disease, parenteral support should be adjusted and GATTEX treatment reassessed. If significant
cardiac deterioration develops while on GATTEX, continued GATTEX treatment should be reassessed.
Discontinuation of treatment with GATTEX may also result in fluid and electrolyte imbalance. Fluid and electrolyte status should be monitored in patients who discontinue treatment with GATTEX.
Increased absorption of concomitant oral medication
In clinical trials, one
patient receiving prazepam concomitantly with GATTEX experienced dramatic deterioration in mental status
progressing to coma during first week of GATTEX therapy. Patients receiving concomitant oral drugs requiring
titration or with a narrow therapeutic index should be monitored for adverse reactions due to potential
increased absorption of the concomitant drug. The concomitant drug may require a reduction in dosage.
Adverse Reactions
The most common adverse reactions (≥ 10%) with GATTEX are
abdominal pain, nausea, upper respiratory tract infection, abdominal distension, injection site reaction,
vomiting, fluid overload, and hypersensitivity.
Use in Specific Populations
Breastfeeding is not recommended during
treatment with GATTEX.
Please click here for full Prescribing Information or Información de prescripción en español.