Can the Antisecretory Factor Be Considered a New Therapy for the Short Bowel Syndrome?

BACKGROUND AND OBJECTIVE: The antisecretory factor (AF) exerts antisecretory and anti-inflammatory properties in the bowel. The aim of this study was to evaluate the effect of exogenous AF (Salovum) or cereals stimulating the endogenous AF (SPC-Flakes), given alone or in combination, in patients with short bowel syndrome (SBS). METHODS: Patients received Salovum alone at T(0) -T(1), Salovum plus SPC-Flakes at T(1) -T(2), and SPC-Flakes alone at T(2) -T(3). At T(0) and T(3), water balance, weight, lean mass (FFM), total body water (TBW), extracellular water (ECW), and nutritional and inflammatory biochemical parameters were evaluated. The water balance was also measured at T(1), T(2), and 30 days (T(S)) from the end of treatment. RESULTS: Among the 7 patients enrolled, 2 discontinued treatment due to side effects and 1 was excluded after a cancer was diagnosed. Salovum alone or with SPC-Flakes did not improve the intestinal absorption in patients with SBS, while the administration of SPC-Flakes alone lead towards a trend of increased faecal volume. Weight, FFM, TBW, and ECW, as well as nutritional and inflammatory status, did not statistically change at the end of treatment (T(3)) as compared with T(0). At T(S) water balance was restored. CONCLUSION: The administration of exogenous AF or the stimulation of endogenous AF seems to be unable to offer an effective therapy in patients with SBS. On the contrary, their administration appears to aggravate fluid loss and induce side effects.