The Intestinal Rehabilitation Program team at Johns Hopkins All Children’s Hospital treats patients with short bowel syndrome, severe gastrointestinal dysfunction and intestinal failure.

Our program provides treatment and management for patients with intestinal disorders, including short bowel syndrome (also called intestinal failure or short gut syndrome). Children with short bowel syndrome require specialized nutritional support and long-term follow-up care.

Our patients receive follow-up care in our Intestinal Rehabilitation Clinic, which takes a team approach to treating our patients in an outpatient care setting. Patients receive care from our multidisciplinary CUIRE (Care Under Intestinal Rehabilitation Excellence) team, with specialists and subspecialists from across our hospital joining together to meet a patient's needs all in one location. Normally, our patients see a variety of these specialists in just one clinic visit.

We use an aggressive medical, surgical and nutritional approach to help increase intestinal adaptation and function and avoid transplants if at all possible. With this approach to treatment, many children with intestinal failure will experience intestinal adaptation, a process where the bowel will adapt and function enough to remove the IV nutrition.

Short Bowel Syndrome (SBS)

Short bowel syndrome is a condition caused by loss of function of the small intestine. The small intestine is an important part of the digestive tract. It’s where the body absorbs certain nutrition and fluids like vitamins, sugars, fats and minerals. If left untreated, SBS can lead to malnutrition and dehydration.

Short Bowel Syndrome Causes and Symptoms

Short bowel syndrome and intestinal failure can occur in a variety of ways, including an intestinal disorder at birth, intestinal trauma, loss of blood supply to the gut and surgical removal of large sections of diseased bowel.

Symptoms of short bowel syndrome are often related to the body’s inability to absorb food, including:

• Abdominal pain
• Dehydration
• Diarrhea
• Vomiting
• Weight loss

Disorders Associated with Short Bowel Syndrome

Our team cares for short bowel syndrome and intestinal failure resulting from the following disorders:

• Autoimmune enteritis
• Gastroschisis
• Hirschsprung disease
• Intestinal atresia
• Intestinal polyposis
• Intestinal pseudo-obstruction
• Microvillus inclusion disease
• Necrotizing enterocolitis (surgical NEC)
• Omphalocele
• Volvulus

Treatment Approach

Our team designs a rehabilitation and management plan for each patient and reviews the patient’s medical care with the referring team on a regular basis.

Our plan of care involves the following strategies:

Research

We work with Johns Hopkins Medicine databases to use best practices for parenteral nutrition associated with liver disease (PNALD), also known ­as intestinal failure-associated liver disease, which can lead to liver failure and cirrhosis. Our team follows outcomes, and monitors and improves growth ­and long-term neurological outcomes of patients with chronic illnesses.