Short bowel syndrome (SBS) is the malabsorption of nutrients caused by removal of small intestine and in rare cases, the dysfunction of particular segments of the bowel. Nutrients are absorbed by the small intestine with the help of villi that are connected to blood capillaries. The condition is extremely rare and affected people exhibit symptoms such as abdominal pain, diarrhea, dehydration, weight loss, fatigue, malnutrition and weakness. Deficiencies of major nutrients such as vitamins and minerals can cause a host of other illnesses and disorders such as swelling, easy, bruising, difficulty in blood clotting, reduced immunological response, anemia, hyperkeratosis, bone and joint pain due to osteoporosis. The condition is also known as Small Intestine Insufficiency.
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Surgical removal of small intestine can occur mainly under three conditions; necrotizing enterocolitis that is the death of intestinal wall due to reduced blood supply, malformation of intestine and Crohn’s Disease which is a condition that causes inflammation of the bowel wall and attacks all parts of the digestive tract, from mouth to anus, for unknown reasons. Crohn’s Disease is a fairly uncommon disease that affects approximately 4.5 million people across the world. According to data from CDC, NIH and other organizations, incidence of Crohn’s Disease is estimated to vary between 0.1–16/100,000 persons worldwide as of 2014. Extrapolation of abdominal surgery procedures indicate that approximately 3 million small bowel resection surgeries may be performed each year that include duodenectomies, Jejunectomies and ileectomies.
There are several methods for testing and diagnosing short bowel syndrome based on the symptoms and body functions. Blood chemistry tests such as albumin level test indicates if the body has reduced nutrient contents. Other tests include complete blood count, fecal fat test, small intestine x-ray and vitamin level blood tests. These laboratory tests are easily available and can be performed as an outpatient setting. High calorie diet, vitamin supplements, carbohydrates, protein and fat enriched foods are the essential treatment options for patients suffering from SBS. Under duress, a patient can also be treated with parenteral nutrition.
Medications for this disorder include drugs that slow bowel movement as a result of which, food remains in contact with the intestines for a longer time giving a chance for greater absorption of nutrients. In 2012, Gattex (teduglutide) has been one of the latest drugs to be approved by the FDA for SBS. Octreotide Acetate Injection is also considered as an off-label treatment drug for SBS. Sandostatin (Octreotide Acetate Injection) and somatostatin are manufactured by a number of companies such as TEVA pharmaceuticals, Wockhardt, Sandoz, Bioniche Pharma, Sun Pharmaceuticals, Sandostatin LAR and Novartis among several others.
Geographically market is dominated by developed economic countries due to government intervention and presence of advanced healthcare facilities have essentially contributed in generating revenues. Currently in United States approximately 10,000 – 20,000 people in the United States suffers from short bowel syndrome. Increasing awareness and inclination of companies in gaining access to European marketing approval has significantly contributed in escalating market for SBS in European countries.
The market for SBS in Asia Pacific and Rest of the World is currently a growing stage. Owing to large population base and lack of hygienic food and burgeoning intestinal and digestion disorders is expected to grow the market in forthcoming years.
Some of the leading players operating in the global Short bowel syndrome market comprises Takeda Pharmaceutical Company, NPS Pharmaceuticals, TEVA pharmaceuticals, Novartis International AG, XTEND and others.
In March 2013 the United States based NPS Pharmaceuticals reacquired worldwide marketing rights for short bowel syndrome drug Revestive from Takeda Pharmaceutical Company Limited. Additionally in September 2012, Revestive has already got European marketing authorization for treating adults with SBS. In December 2012 Teduglutide, a new drug got FDA approval for treating patients suffering with SBS and are dependent on parenteral nutrition or intravenous therapy.
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