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Intestinal rehabilitation includes strategies and therapies designed to make the bowel work better, such as nutritional support, nutritional rehabilitation, medical management and restorative surgery. Intestinal rehabilitation is a potential strategy for anyone with short bowel syndrome of other GI dysfunction.
Nutrition support may be a combination of feeding by a tube into the stomach or intestine, enteral nutrition (EN), or by a catheter placed into your vein, parenteral nutrition (PN). Nutritional rehabilitation is the process of supplementing oral feeding to make sure enough calories are obtained while increasing oral intake by methods that may include speech/occupational therapy.
Medical management may include medications such as antidiarrheal agents, antisecretory agents, and bile acid regulators. Nutritional supplements may also be added to prevent nutrition-related complications that are common in patients with short bowel syndrome such as B12 and Vitamin D deficiencies. Additionally, changes to intake and source of fats may be implemented to manage PN-related liver disease and thereby delay the need for transplantation.
Surgical procedures on the native gastrointestinal tract can improve both the function and the absorptive surface area of the remaining bowel. Appropriate surgical decisions regarding the role and timing of autologous reconstructive procedures such as longitudinal intestinal lengthening (Bianchi procedure) and serial transverse enteroplasty (STEP) require an individualized surgical assessment. Optimal long term outcomes occur when these procedures are coordinated with intestinal rehabilitation provided by multidisciplinary centers.
The Intestinal Rehabilitation Program (IRP) is a multidisciplinary program that provides consultation, management and long-term follow-up for children and their families coping with intestinal failure and short bowel syndrome. The program treats patients from all over the world; we’ve grown into a respected leader in the field, thanks to our innovative and multidisciplinary approach to reaching the best outcomes for our patients and their families.
When your child comes to our program for treatment, he or she is evaluated by a team of experts. Our pediatric surgeons, gastroenterologists, neonatologists, psychologists, nutritionists and nurses all have experience in managing children with long-term total parenteral nutrition (TPN) and intestinal failure. In addition, we collaborate with world-class feeding and pediatric motility experts to comprehensively treat your child’s digestive disorder. We also work with social workers and child developmental specialists; this broad range of specialties ensures that, whatever challenges your child and your family face, we have the knowledge and resources to help.
The IRP team provides medical and surgical management of a number of intestinal dysfunction disorders, including but not limited to these:
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