Chronic intestinal failure and short bowel syndrome in Crohn’s disease

Table 5 Symptomatic treatment options in short bowel syndrome

Symptom	Drug/therapy	Dose (per day)
Gastral hypersecretion	Proton pump inhibitors	20-40 mg i.v. (p.o.)
	Clonidine	2 × 75-150 µg s.c./p.o.
	Octreotide (sandostatin)1	3-4 × 50-100 µg s.c.
Hypermotility	Loperamide	4-6 mg p.o. (max daily dose 16 mg)
	Diphenoxylate	4 × 2.5-7.5 mg (max daily dose 20-25 mg)
	Codeine	30 mg p.o.
	Opium tincture	4 × 0.3-1 mL (10-60 mg) p.o.
Secretory diarrhea	Octreotide (sandostatin)1	2-3 × 50-100 µg s.c.
	Budesonide (e.g., entocort)	3 × 3 mg p.o.
	Clonidine	2 × 75-150 µg s.c.
Fat malabsorption	Pancrelipase (e.g., Creon)	40000 IU with main meals (15000 IU with snacks)
Lactose malabsorption	Lactase formulations (L-products)	Depending on severity
Reduced fluid resorption	Locust/carob bean gum flour added to drinks (yoghurt)	Approx. ½-1 tablespoon per glass/pot
	Kaopectate (kaolin/pectin)	4 × 1 tablespoon

¹Not in the adaptive phase.