Intestinal rehabilitation involves dietary management with very precise control of metabolic balance, and prompt and effective treatment of complications. We closely monitor nutrition for normal growth, maintenance of optimal fluid and electrolyte balance, and management of potential concerns.
Multiple therapies must be undertaken to provide the best management to allow for eventual weaning of parenteral nutrition. The care of these patients is complex and requires an interdisciplinary management team, including a gastroenterologist, surgeon, dietitian and general nurse and social support.
Children’s National offers the most advanced non-transplant surgical options for treatment for intestinal failure, with the goal of improving intestinal absorption and bowel function. These include small bowel reconstruction, and bowel lengthening procedures, such as the Bianchi and STEP (serial transverse enteroplasty), performed by some of the most highly trained pediatric surgeons.
Patients with intestinal failure encounter multiple acute and chronic problems. The real challenge in patients with intestinal failure comes from managing the many chronic complications that arise. The most common problems that can be found in the acute or chronic stages are diarrhea, fluid and electrolytes abnormalities, and nutrient loss.
Many of the chronic complications come from the use of intravenous feeding, including catheter-associated infection, cholestasis-hepatic dysfunction (intestinal failure associated liver disease), metabolic complications, demineralization of bone, rickets and progressive renal insufficiency.
Children’s National works closely with the MedStar Georgetown Transplant Institute, in the instance that patients need a transplant.