If your child suffers from short bowel syndrome or intestinal failure, you want comprehensive care by a multidisciplinary team of experts, who specialize in the digestive health of children. At the Children's Intestinal Rehabilitation Program at Mott Children's Hospital, part of the University of Michigan Health System, our sole focus is your child’s nutritional and gastrointestinal care. We offer the full spectrum of services, from medical and nutritional management to surgical services.
We see children from newborn to 18 years of age with a variety of intestinal problems and needs, including:
- Difficulty maintaining weight and hydration without receiving total parenteral nutrition (feeding through an intravenous catheter) or intravenous catheter hydration
- Short bowel syndrome (a disorder characterized by diarrhea, malabsorption, fluid and electrolyte Imbalances, and the surgical removal or functional loss of the small intestine)
- Intestinal dysmotility (muscles of the gastrointestinal tract don’t work normally)
- Complex surgical problems, which prevent adequate nutritional intake
- Specialized tube feedings for fluid or nutrients
- The need to reduce diarrhea and control volume of stool output
Our clinical team specializes in the challenges presented by the small, developing bodies of children and includes a pediatric gastroenterologist, a pediatric surgeon, a registered dietician, a registered nurse, a clinical pharmacist and a clinical social worker. Our team also receives support from Child Psychiatry and Occupational Therapy for working with children who have eating disorders.
Due to the complex nature of short bowel syndrome and intestinal failure, clinical appointments can be long. Appointment lengths are typically 1.5 hours for new patients and 1 hour for return visit hours. After check in, a nurse will take your child’s height, weight, temperature, pulse and blood pressure readings. You and your child will then have a short visit with each team member separately. Towards the end of the appointment, the entire clinical team will come together to see the patient,then go over changes to medications and nutritional guidelines, and create a plan of care, which is provided to you and your child as well as your referring physician.
All patients also undergo a complete nutritional analysis. Our physicians and dietitians work closely to determine recommendations regarding optimal total parenteral nutrition management, fluid and electrolyte management and special diet designed to meet your child’s specific needs. The goals include increasing weight normalizing weight gain and linear growth, decreasing stool output, improving hydration and improving nutrient deficiencies. And, for short bowel syndrome patients, our objective is to get the remaining intestines to adapt and support nutritional absorption.
Surgical options include a number of methods to taper the intestine in hopes of improving intestinal movement and preventing the development of bacterial overgrowth. Other surgical methods lengthen the intestine. . These include the Bianchi method and the more recent STEP procedure. All of these options may be considered in patients with short bowel syndrome, however, they are used only after it is clear that medical management is not effective in weaning your child off total parenteral nutrition. Routine gastrointestinal surgeries, including feeding tube placement and management and antireflux procedures are also provided.
Our individualized care goes beyond improving long-term survival and support for children living with short bowel syndrome and intestinal failure. Ongoing parent education and family support are also important components of our program.
We are also working with researchers at both the University of Michigan and the National Institutes of Health to develop ways to actually grow the small bowel in length. This novel approach is contributing towards potential major advances in the treatment of short bowel syndrome.