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The Role of TPN in Crohn’s Disease and Ulcerative Colitis: What is it and Why is it Used?

Have you ever heard someone who has Crohn’s disease or ulcerative colitis mention that they are on TPN but don’t know that means? Today’s post is all about the role TPN plays in Inflammatory Bowel Disease. I have been on TPN many times so I will include some of my personal experience in this to compliment the information. So what is TPN? 

What Is TPN?

Total Parenteral Nutrition

‘Parenteral’ means to eat (-enteral) through an IV (par-). 

TPN, or Total Parenteral (pronounced pah-wren-tur-ull) Nutrition, in the simplest way to describe it is to receive nutrition through your veins and into the bloodstream. To go more in-depth, it is used to feed a person intravenously to bypass the normal process of eating and digestion. Basically you won’t be eating by mouth and food will not be traveling through your digestive tract. You’ll be “eating” through your veins. Unless you are on PPN (Partial Parenteral Nutrition) and then you can eat by mouth in addition to receiving intravenous nutrition. But we will get to that in a bit! 

To receive TPN a patient will need to have a central line placed because the solution is very concentrated and can cause thrombosis to peripheral veins. A pharmacist who has special training to make parenteral nutrition will make the solution specifically for you based off of your blood work, weight, health conditions, and other factors. The TPN solution will contain all of the calories and nutrients you require for the day. 

People can receive TPN at the hospital or at home. If you are in the hospital the bag of TPN will be hung from an IV pole and an IV pump will pump the solution into your veins through IV tubing.  If you are at home with TPN you can put everything in a backpack so you can take it everywhere you go and not have to be connected to an IV pole the entire time. One bag of TPN supplies the calories and nutrients you need for 24 hours. You start another bag of TPN 24 hours after the previous bag. You will need 7 bags per week unless your medical team decides otherwise. 

Typically people only need TPN for a short period of time but some people need it long term. Some people can eat food while they are on TPN and others cannot eat anything by mouth and must rely on the TPN completely. The reason the person is put on TPN and the goals for it’s use determine whether or not it is possible to eat in addition to being on TPN. 

TPN Fast Facts

Why is TPN used for IBD?

Diagram of how TPN works showing where a PICC line enters my body and where it lays above the heart along with how the pump and IV bag work
BEHIND THAT CURTAIN WAS A ROOMMATE FROM HELL
  • Bowel obstruction – stricture, volvulus, adhesions, etc. 
  • Temporary ileus after abdominal surgery. 
  • Nutritional depletion.
  • The small bowel can’t absorb nutrients properly. 
  • The patient needs to “rest” the bowel by not having any food pass through them in order to help it heal. 
  • The patient is having a difficult time eating enough food after surgery or during a flare. 
  • Severe weight loss. 
  • Short bowel syndrome – usually caused by multiple resection surgeries.
  • Prolonged diarrhea.
  •  High output fistula. 
  • Get a patient in better health in preparation for surgery.
  • To supply nutrients required to help a patient heal after surgery.

Benefits & Risks/Disadvantages of TPN

Benefits

RISKS

Even though TPN has a lot of benefits it should only be used when absolutely necessary as it comes with some serious risks. Every attempt to use the alimentary tract first should be made unless unwise to do so. Some of these risks may seem like no big deal but many can be life threatening. It is important to work with your medical team while you are on TPN to reduce these risks.

I hope this has helped explain what TPN is and why it might be used for someone who has Crohn’s disease or ulcerative colitis. 

Looking in the mirror with my IV pole next to me and on it hangs TPN.
Standing in my bathroom running TPN

Sara

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