Time Off TPN Emerging as Key Goal in Short Bowel Syndrome Care, With Syed-Mohammed Jafri, MD

Short bowel syndrome (SBS) remains a life-altering condition, often requiring lifelong reliance on parenteral support to maintain nutrition and hydration. While these therapies are lifesaving, new data presented at Digestive Disease Week (DDW) 2026 in Chicago, IL, highlight a growing recognition among clinicians: the burden of total parenteral nutrition (TPN) extends far beyond clinical stabilization, with significant implications for safety, complications, and quality of life.

Patients with SBS dependent on parenteral support face substantial clinical and lifestyle challenges due to reduced intestinal function. TPN remains the cornerstone of management, but it is associated with a range of complications, including infections, thrombosis, and liver injury.

“We have been continuing to work with patients with short bowel syndrome now for over 15 years, and following these patients over time and really seeing the tough life that they lead,” Syed-Mohammed Jafri, MD, a gastroenterologist and transplant hepatologist at Henry Ford Hospital, told HCPLive.

The data presented at DDW stemmed from a noninterventional, cross-sectional online survey conducted among HCPs in the US and Europe with ≥2 years of experience treating SBS patients and actively managing ≥1 patient. The survey assessed perceptions of TPN-related complications, clinical burden, and preferred outcome attributes for potential new therapies.

HCPs reported a high burden associated with TPN in patients with SBS dependent on parenteral support, with central line complications, fatigue, and decreased QoL being primary concerns. Reducing time on TPN was considered more impactful than volume reduction.

Moving Beyond Stabilization

According to Jafri, the traditional focus on stabilization represents only the first phase of care, pointing to the need for a more comprehensive, long-term management strategy . While TPN can prevent malnutrition and stabilize electrolytes, it also introduces new risks that must be actively managed over time.

The study findings reinforce this perspective, showing that healthcare professionals prioritize minimizing complications and keeping patients out of the hospital. However, there is increasing awareness that treatment goals must extend beyond safety alone.

Time Off TPN Emerges as Key Priority

A central theme of the research is the importance of reducing the burden of TPN, particularly in terms of time. Nearly half of surveyed clinicians identified reducing the number of days per week on TPN as the most valuable outcome, followed by reducing hours per day. By comparison, fewer respondents prioritized reducing infusion volume.

This aligns closely with patient experiences. Many individuals require TPN infusions for up to 12 hours daily, limiting their ability to work, socialize, or leave home. As Jafri noted, patients often seek “a break” from therapy to regain a sense of normalcy in their daily lives .

Beyond quality of life, reducing time on TPN is also clinically beneficial. Fewer infusion hours and days may reduce exposure to central venous catheters, thereby lowering the risk of infections and thrombosis, 2 of the most serious complications identified in the study.

Implications for Clinical Practice and Future Research

These findings signal a shift in how clinicians approach SBS management. While maintaining stability and preventing hospitalizations remain critical, there is growing emphasis on balancing these goals with quality of life considerations. Actively pursuing strategies to wean patients from TPN when feasible is becoming an increasingly important aspect of care.

Looking ahead, there remains a need for innovative therapies that reduce dependence on parenteral support while maintaining nutritional adequacy. Advances in intestinal rehabilitation, improved delivery methods, and novel pharmacologic agents may all contribute to this goal.

Equally important is increasing awareness of SBS within the gastroenterology community. Early recognition and referral to specialized centers can help ensure patients receive comprehensive care tailored to both clinical and lifestyle needs.

References

1. Jafri SM, Harrison J, Kumpf V, et al. BURDEN OF TOTAL PARENTERAL NUTRITION FOR PATIENTS WITH SHORT BOWEL SYNDROME DEPENDENT ON PARENTERAL SUPPORT: HEALTHCARE PROFESSIONAL PERSPECTIVES ON RISKS, LIMITATIONS, AND TREATMENT PRIORITIES. Presented at Digestive Disease Week (DDW) 2026; Chicago, IL; May 2–5, 2026.