Endocrine Abstracts

Gastroenteropancreatic Neuroendocrine Tumours (NETs) may lead to gastrointestinal symptoms directly or as a result of their treatment, for example surgical resection and/or somatostatin analogues (SSA). When these symptoms become severe, patients may develop a reduced ability to successfully digest and absorb nutrients in the diet. This may be specific due the area of resection, e.g. vitamin B12, or secondary from medication, e.g. SSA induced pancreatic exocrine insufficiency leading to fat soluble vitamin malabsorption, but more often this may affect a variety of macro- and micro-nutrients, and in severe cases electrolytes and hydration status. Identification of the aetiology of the symptoms leading to the loss of nutritional autonomy is vital to managing and improving the situation. Multi-disciplinary working between gastroenterologists (with a clinical nutrition interest), dietitians and the NET team is vital in maximising nutritional response. In extreme circumstances, resection may lead to short bowel syndrome and intestinal failure where the ability to digest and absorb the diet falls below a level that can sustain life. Whilst medical regimes to treat short bowel syndrome and oral nutritional support may help, home parenteral nutrition may be required. Whilst this raises a whole new level of complexity to care, it can be successfully employed with the Nutrition Support Team (NST), restoring both prognosis and quality of life.