IBD and TPN
TPN stands for total parenteral nutrition. It is usually used in emergency situations only. So how are IBD and TPN related? TPN is used in patients with IBD who are experiencing other complications of the disease.
It is not recommended to use TPN as a first line treatment for IBD. TPN can provide bowel rest, and enough calories and nutrition to sustain the patient.
To learn more about IBD and TPN, we will discuss:
- What is TPN?
- Does TPN help heal IBD?
- When is TPN used?
- My experience with TPN
What Is TPN?
TPN stands for total parenteral nutrition. It is nutrition given intravenously.
The liquid nutrition source consists of protein, carbohydrates, glucose, fat, minerals, and vitamins. These are mixed in a solution of water. The mixture should be customized to the patient’s individual needs. TPN can be administered for a few days, or weeks at a time.
A small pump pumps the nutrition into the body. And via a large vein (often in the arm) the nutrition is pumped directly to the heart.
TPN is often administered in a hospital. But TPN can also be administered at home, especially in long term situations. When administered at home it must only be used under the care of a qualified home nurse.
Does TPN Heal IBD?
The short answer to this is no.
TPN is not used to cure or heal IBD. It is a technique used to heal malnourishment, which can occur as a result of IBD.
It has been found that there is no increase in remission rates due to TPN use
Although TPN itself does not heal IBD. There is a connection between receiving enough nutrition, and healing the gastrointestinal tract. So if TPN can help provide that nutrition, it may help heal the bowel, although this has not been proven.
When is TPN Used?
TPN is often used in life threatening situations.
It is used in patients with Crohn’s disease more often than in patients with ulcerative colitis.
TPN is used more often with children and teenagers than in adult patients. This is because being malnourished can cause growth and developmental delays in young people.
TPN is used in a variety of cases. It is used in patients who are suffering from malnourishment. Also in patients with complications of IBD, who may need bowel rest. This could be due to a recent surgery.
It is also used in patients with short bowel syndrome. Where the patient does not have enough small intestine to absorb adequate nutrients from food.
TPN can be administered in patients with an intestinal blockage. Who are unable to receive nutrition via mouth.
TPN has been proven to correct malnutrition in patients. It promotes wound healing, and prevents dehydration, as well as prevents further malnourishment.
My Experience with IBD and TPN
I was administered TPN in 2020 for four days while in hospital. It was after my emergency abscess surgery and was given for two reasons.
First because I had just surgery, and the doctor wanted to give my bowel time to rest. This digestive rest would allow my body to focus on healing from the surgery.
Secondly, I was given TPN because I was severely malnourished. I was extremely underweight at 42kgs. I was too weak to stand without support. I had been in a very bad IBD flare for the past eight months.
I was also experiencing strong food aversion, and food fear at this time. I had basically stopped eating, and had no desire to eat anything at all. Anytime that I would eat I would experience horrible symptoms. Including bloody BM’s, vomiting, and nausea.
The doctor did not want to release me from the hospital until I had gotten some nutrition into my body.
At first I was scared to receive the TPN. No one likes receiving needles, and I did not want to have a needle in me for four days non-stop. But I knew that I was very unwell, and was desperate to try something new.
Once I got used to the TPN, I felt so relieved. Before the TPN, there was a lot of pressure for me to eat food. With the TPN, I just sipped fresh juices, and ate a small amount of food. The pressure for me to eat was no longer there. As I was receiving enough calories intravenously. I did not feel hungry at all, as the TPN satisfied my hunger.
This was a huge relief for me. Honestly, I hated eating at this point. And hated how skinny and frail my body was. The TPN saved me.
After seven days in the hospital, and four of them on TPN I was released and able to go home.
Unfortunately I experienced side effects of the TPN. The vein where the nutrition had been going in became very painful.
It felt as if the vein had become stiff, and I could not extend my arm fully. I experienced these symptoms for more than three weeks. It felt like the TPN had damaged my vein. Which it may have; your veins aren’t made for pumping nutrition into the body. They are made to circulate blood.
This pain was excruciating for at least 10 days. I could not use my hand, or arm. And had to walk around with it bent at the elbow. I even used a sling for a few days to make it easier to hold my arm still.
Eventually the pain subsided, and I have had no long term effects from the TPN.
Although it has been shown that TPN does not necessarily induce remission in IBD. My experience was that before the surgery and TPN, I was in a horrible IBD flare.
After the surgery and TPN, I did not feel like I was in an IBD flare anymore. My appetite returned. I was eating entire plates of food three days out of hospital, without IBD symptoms.
I cannot say for certain what healed that IBD flare. But I do know that bowel rest has helped heal me before. I believe that the bowel rest, the high nutrition of the TPN and the removal of the abscess. Put me into symptom-free remission. I do not know if I was in clinical remission at this time, as I was not tested.
TPN is usually only used in emergency situations. It has not been shown to heal IBD. But it can undoubtedly help patients who are experiencing malnourishment.
Although it has not been shown to heal IBD. It may save the life of an IBD patient who cannot tolerate food via the mouth.
My experience with TPN was positive overall.