Total parenteral nutrition, or TPN, is an intravenous feeding method used when feeding or tube feeding does not provide adequate nutrition. TPN provides nutrients directly into the bloodstream, bypassing the gastrointestinal tract. This feeding method can be lifesaving if a condition prevents you from absorbing nutrients properly.
Short Bowel Syndrome
Short bowel syndrome occurs when a person has significantly less small intestine than usual due to surgery or disease, making it difficult to absorb enough nutrients from food to stay healthy. In such cases, TPN nutrition is often used to provide supplemental or total nutrition while the remaining bowel adapts and improves its absorptive capacity. TPN allows you to receive adequate calories, protein, fluids, electrolytes, vitamins, and minerals directly into your bloodstream, bypassing the digestive system, even if your small intestine cannot absorb enough nutrients from your diet.
Crohn’s Disease
An inflammatory bowel condition called Crohn’s disease results in ulcers and inflammation in the digestive system. This may result in weight loss, diarrhea, gastrointestinal pain, and malabsorption of nutrients. TPN may be necessary during Crohn’s disease flare-ups to supply fluids, protein, and calories that your body cannot correctly absorb from your diet. When bowel rest is required due to severe cases, total parenteration (TPN) may offer full nutritional support until the illness activity subsides.
Radiation Enteritis
Radiation therapy to the abdomen and pelvis can damage the lining of the small intestine, causing radiation enteritis. This condition impairs your ability to digest and absorb nutrients properly. If radiation therapy has significantly impacted the functioning of your small intestine, TPN may be used to supplement or provide your nutrition. TPN can help you maintain weight, strength, and energy levels while your intestine heals.
Intestinal Pseudo-Obstruction
Intestinal pseudo-obstruction refers to motility disorders that prevent the proper passage of food and stool through the intestines. This leads to symptoms like nausea, vomiting, bloating, and constipation. Pseudo-obstruction can make it hard to absorb enough nutrition orally or through a feeding tube. TPN may be utilized to provide nutrition directly into the bloodstream. It can be a bridge to stabilize your nutrition while the underlying condition is treated.
Severe Pancreatitis
Acute pancreatitis, especially in its most severe forms, can make it difficult to digest and absorb nutrients properly. The inflamed pancreas has trouble producing digestive enzymes needed to break down food. TPN is often used as a temporary nutrition solution in severe cases of pancreatitis. It provides calories, protein, and nutrients directly into the blood until the pancreatitis improves enough to tolerate feeding by mouth or tube.
Major Gastrointestinal Surgery
After major surgery on your esophagus, stomach, pancreas, or intestines, you may not be able to absorb adequate nutrition orally or through a feeding tube. Gastrointestinal surgeries like gastrectomies, pancreaticoduodenectomy, and colectomies can disrupt digestion and absorption for some time after the operation. TPN is commonly used to provide nutrition during recovery until you can return to full enteral feeds.
Severe Malnutrition
Certain conditions like anorexia nervosa, cancer, or gastrointestinal diseases can lead to severe protein and calorie malnutrition. If you become dangerously underweight and malnourished, feeding by mouth or tube may not provide sufficient nutrition quickly enough for recovery. TPN can rapidly provide concentrated nutrition to stabilize your health if you are malnourished. It serves as a bridge to allow you to gain strength until you can transition to full oral or tube feeding.
Premature Infants
Premature infants are born before their gastrointestinal systems have fully developed. This can make it challenging for them to coordinate sucking, swallowing, and breathing to feed effectively. Their immature intestines also have difficulty properly absorbing nutrients. TPN is commonly used in premature babies to provide essential nutrition until they mature enough to take full enteral feeds by breast or bottle.
Summary
TPN, or total parenteral nutrition, is a lifesaving intravenous feeding method used when you cannot absorb adequate nutrition through your gastrointestinal tract. It is an essential therapy for patients with short bowel syndrome, Crohn’s disease, radiation enteritis, and many other conditions that impair digestion and absorption.
If you require TPN, work closely with your medical team to transition back to oral or tube feeding as soon as your condition stabilizes. With specialized nutrition care, TPN can help you on the road to recovery.
This article was written for WHN by Dr. Alex Morgan who is a gastroenterologist with over 15 years of experience in digestive health. Specializing in conditions requiring Total Parenteral Nutrition (TPN), he is dedicated to improving patient outcomes through personalized nutritional care.
As with anything you read on the internet, this article should not be construed as medical advice; please talk to your doctor or primary care provider before changing your wellness routine. WHN does not agree or disagree with any of the materials posted. This article is not intended to provide a medical diagnosis, recommendation, treatment, or endorsement. These statements have not been evaluated by the Food and Drug Administration.
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References/Sources/Materials provided by:
https://nutrishare.com/tpn-blog/what-is-tpn-and-how-does-home-tpn-work/
https://my.clevelandclinic.org/health/treatments/22802-parenteral-nutrition
