Effectiveness and safety evaluation of terlipressin in the treatment of intestinal paralysis in end-stage liver disease

Abstract Background and aims Intestinal paralysis is a common complication in end-stage liver disease (ESLD), our aim is to assess the effectiveness and safety of low-dose terlipressin for treating intestinal paralysis in ESLD. Methods The study was divided into two phases, in the exploratory phase,...

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Main Authors: Xia Wan, Hua Xu, Hu Li, Shan Zhong, Yu Lei, Huan Deng, Xiao Fu, Zhi Zhou
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Gastroenterology
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Online Access:https://doi.org/10.1186/s12876-025-03910-2
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author Xia Wan
Hua Xu
Hu Li
Shan Zhong
Yu Lei
Huan Deng
Xiao Fu
Zhi Zhou
author_facet Xia Wan
Hua Xu
Hu Li
Shan Zhong
Yu Lei
Huan Deng
Xiao Fu
Zhi Zhou
author_sort Xia Wan
collection DOAJ
description Abstract Background and aims Intestinal paralysis is a common complication in end-stage liver disease (ESLD), our aim is to assess the effectiveness and safety of low-dose terlipressin for treating intestinal paralysis in ESLD. Methods The study was divided into two phases, in the exploratory phase, we retrospectively analyzed the clinical data of patients with intestinal paralysis treated with low-dose terlipressin and explored its efficacy. In the clinical research phase, we designed a prospective cohort study, patients with intestinal paralysis were categorized into terlipressin treatment group (low-dose terlipressin was added to the conventional treatment) and conventional treatment group according to their wishes. The remission of intestinal paralysis, time to symptom remission, and differences in adverse reactions were compared between the two groups. Results In the exploratory phase, 26 patients were exposed to low-dose terlipressin, 12 were cured, 11 were moderately effective, and 3 were ineffective. The mean time to abdominal bloating remission was 2 days, and the time to anal flatus and feces passage was 1 day. In the clinical research phase, a total of 131 patients were included at baseline, with the exception of one patient who discontinued medication due to severe vomiting, resulting in a final total of 130 patients included in the analysis. The mean time to abdominal pain and bloating remission in the terlipressin treatment group (32/130) was demonstrably shorter compared to the conventional treatment group (98/130) (P < 0.001), the mean time to anal flatus and feces passage was also shorter (P < 0.001), and the remission rate was higher (P < 0.05). The incidence of adverse events was similar. Conclusions Low-dose terlipressin treatment could considerably increase intestinal paralysis remission in ESLD patients with intestinal paralysis, and have good safety.
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spelling doaj-art-59ac3a5eae6b4c36ae07ebc4f88eb3712025-08-20T03:13:58ZengBMCBMC Gastroenterology1471-230X2025-04-012511910.1186/s12876-025-03910-2Effectiveness and safety evaluation of terlipressin in the treatment of intestinal paralysis in end-stage liver diseaseXia Wan0Hua Xu1Hu Li2Shan Zhong3Yu Lei4Huan Deng5Xiao Fu6Zhi Zhou7Department of Infectious Diseases, Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, the Second Affiliated Hospital, Chongqing Medical UniversityDepartment of Infectious Diseases, Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, the Second Affiliated Hospital, Chongqing Medical UniversityDepartment of Infectious Diseases, Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, the Second Affiliated Hospital, Chongqing Medical UniversityDepartment of Infectious Diseases, Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, the Second Affiliated Hospital, Chongqing Medical UniversityDepartment of Infectious Diseases, Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, the Second Affiliated Hospital, Chongqing Medical UniversityDepartment of Infectious Diseases, Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, the Second Affiliated Hospital, Chongqing Medical UniversityDepartment of Infectious Diseases, Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, the Second Affiliated Hospital, Chongqing Medical UniversityDepartment of Infectious Diseases, Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, the Second Affiliated Hospital, Chongqing Medical UniversityAbstract Background and aims Intestinal paralysis is a common complication in end-stage liver disease (ESLD), our aim is to assess the effectiveness and safety of low-dose terlipressin for treating intestinal paralysis in ESLD. Methods The study was divided into two phases, in the exploratory phase, we retrospectively analyzed the clinical data of patients with intestinal paralysis treated with low-dose terlipressin and explored its efficacy. In the clinical research phase, we designed a prospective cohort study, patients with intestinal paralysis were categorized into terlipressin treatment group (low-dose terlipressin was added to the conventional treatment) and conventional treatment group according to their wishes. The remission of intestinal paralysis, time to symptom remission, and differences in adverse reactions were compared between the two groups. Results In the exploratory phase, 26 patients were exposed to low-dose terlipressin, 12 were cured, 11 were moderately effective, and 3 were ineffective. The mean time to abdominal bloating remission was 2 days, and the time to anal flatus and feces passage was 1 day. In the clinical research phase, a total of 131 patients were included at baseline, with the exception of one patient who discontinued medication due to severe vomiting, resulting in a final total of 130 patients included in the analysis. The mean time to abdominal pain and bloating remission in the terlipressin treatment group (32/130) was demonstrably shorter compared to the conventional treatment group (98/130) (P < 0.001), the mean time to anal flatus and feces passage was also shorter (P < 0.001), and the remission rate was higher (P < 0.05). The incidence of adverse events was similar. Conclusions Low-dose terlipressin treatment could considerably increase intestinal paralysis remission in ESLD patients with intestinal paralysis, and have good safety.https://doi.org/10.1186/s12876-025-03910-2End-stage liver diseaseIntestinal paralysisTerlipressin
spellingShingle Xia Wan
Hua Xu
Hu Li
Shan Zhong
Yu Lei
Huan Deng
Xiao Fu
Zhi Zhou
Effectiveness and safety evaluation of terlipressin in the treatment of intestinal paralysis in end-stage liver disease
BMC Gastroenterology
End-stage liver disease
Intestinal paralysis
Terlipressin
title Effectiveness and safety evaluation of terlipressin in the treatment of intestinal paralysis in end-stage liver disease
title_full Effectiveness and safety evaluation of terlipressin in the treatment of intestinal paralysis in end-stage liver disease
title_fullStr Effectiveness and safety evaluation of terlipressin in the treatment of intestinal paralysis in end-stage liver disease
title_full_unstemmed Effectiveness and safety evaluation of terlipressin in the treatment of intestinal paralysis in end-stage liver disease
title_short Effectiveness and safety evaluation of terlipressin in the treatment of intestinal paralysis in end-stage liver disease
title_sort effectiveness and safety evaluation of terlipressin in the treatment of intestinal paralysis in end stage liver disease
topic End-stage liver disease
Intestinal paralysis
Terlipressin
url https://doi.org/10.1186/s12876-025-03910-2
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