Chronic intestinal failure: challenges, comprehensive management, and the need for universal access to home parenteral nutrition

Abstract

This publication presents the discussions and proposals derived from the roundtable “Coalition Project for the Well-being of Patients with Chronic Intestinal Failure (CIF)”, addressing the causes of this condition and the unmet needs in the Chilean healthcare system for patients living with CIF. Critical challenges were identified, including the urgent need to establish a regulatory framework that guarantees equitable access to both hospital and home parenteral nutrition (PN) and other complementary therapies, the lack of multidisciplinary centers, and the need for a continuity plan between pediatric and adult care in CIF treatments. The objective is to highlight current deficiencies and propose viable solutions for the management of patients with CIF, such as the implementation of clinical guidelines, the creation of specialized referral centers, and the incorporation of new therapeutic alternatives. The importance of a multidisciplinary approach that integrates medical personnel and specialists in complementary areas is emphasized, as well as addressing the biopsychosocial and neurodevelopmental impact that this condition has on patients and their families. This publication reflects the commitment of the participants to move toward a more equitable healthcare system, where the treatment of CIF (especially parenteral nutrition) does not depend on the geographic location or the economic resources of each family but is rather a guaranteed right for all individuals living with this condition.