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Short Bowel Syndrome / Intestinal Failure (Pediatric)

What is short bowel syndrome/intestinal failure?

This condition occurs when a child’s intestines can’t absorb enough nutrients to support proper growth and development.

The most common cause of intestinal failure is short bowel syndrome. It generally develops after part of the small intestine is removed during surgery for necrotizing enterocolitis or to correct an intestinal birth defect (congenital abnormality).

Children may also have normal intestinal length, but the intestine may not function properly due to motility disorders or congenital malabsorption diseases.

Our expert team cares for patients with intestinal failure and short bowel syndrome caused by

  • Necrotizing enterocolitis
  • Congenital intestinal atresias
  • Congenital diarrheal disorders
  • Hirschsprung Disease
  • Gastroschisis
  • Volvulus
  • Motility disorders

What are the symptoms of short bowel syndrome/intestinal failure?

Young patients with intestinal failure often experience:

  • Diarrhea
  • Feeding intolerance
  • Oral aversion
  • Poor growth
  • Malabsorption
  • Fluid and electrolyte imbalance
  • Vitamin and mineral deficiencies
  • Liver dysfunction/cholestasis

How is short bowel syndrome/intestinal failure diagnosed?

Our physicians employ a variety of diagnostic procedures including:

  • Upper endoscopy
  • Colonoscopy
  • Liver biopsy
  • Anorectal manometry
  • Esophageal manometry
  • pH/impedance probe
  • Upper gastrointestinal series
  • Barium enema

We also closely monitor your child’s blood work, including vitamin levels, and supplement as necessary.

How is short bowel syndrome/intestinal failure treated?

Our physicians at the Pediatric Intestinal Rehabilitation Center take a multi-disciplinary approach to the management of patients with intestinal failure.

Your child’s team will include experts from pediatric gastroenterology, pediatric hepatology, pediatric surgery, pediatric infectious disease, neonatology, nutrition, feeding and occupational therapy, radiology, pathology and social work.

Your child will be treated and monitored in our dedicated weekly intestinal rehabilitation clinic by a pediatric gastroenterologist, nurse practitioner and registered dietician. Together, we create a comprehensive plan of care tailored to your child’s specific needs.

Our treatments include:

Intestinal Rehabilitation—strategies and therapies designed to make the bowel work better, such as nutritional support, nutritional rehabilitation, medical management and restorative surgery.

Nutritional support is often given through a feeding tube and/or through total parenteral nutrition (TPN). Here your child receives nutrients through a catheter placed in a central vein. We also provide feeding and occupational therapy to encourage your child to eat by mouth. Our team has also developed special protocols to improve patient outcomes. Our central line-associated bloodstream infection rate is consistently below the national average, and we are working to further minimize central line infections with ethanol lock therapy and individual education of caregivers. We also use lipid minimizing protocols to prevent TPN-associated liver injury.

Medical management using medications to slow down the intestine and to help your child absorb food.

Surgical evaluation. Your child will be closely followed by a pediatric surgeon for possible restorative surgeries to make the intestines more functional.

Transplantation. We offer transplantation surgery to our patients after all other treatment strategies have failed. Our specialists perform isolated small intestine transplantation in children with intestinal failure who have a functioning liver and offer combined liver and intestinal transplantation for patients with both liver and intestinal failure.