Pediatric Intestinal Failure
What does intestinal failure mean?
The small intestine breaks down food from the stomach to the large intestine and is the part of the digestive tract responsible for nutrient absorption. Intestinal failure occurs when an intestine does not function well enough to maintain normal nutrition, which can affect a child’s growth and development.
The most common cause of intestinal failure is short bowel syndrome. A baby can be born with a shorter-than-normal intestine — usually 50 percent or less — or intestine failure can develop during infancy. In addition, a short bowel can occur if a portion of the small intestine is surgically removed because of injury, trauma or disease.
When a child has a shortened bowel, food passes either too quickly or too slowly for the small intestine to do its job properly. This can cause dehydration, malnourishment and bacterial infections.
Intestinal failure can also result from motility disorders such as Hirschsprung's disease, bowel atresia, gastroschisis, congenital diarrheal disorders (CDD) and autoimmune bowel disease and malabsorption.
What are the symptoms for intestinal failure?
- Abdominal pain
- Impaired growth and development
- Nausea and/or vomiting
- Pale appearance
- Poor appetite
- Weight loss or poor weight gain
- Weakness and fatigue
How is intestinal failure diagnoses?
To diagnose intestinal failure, your child’s doctor will do a complete physical exam of your child and ask you about past medical events. There are a number of tests that are useful in diagnosing the condition, and your child’s doctor may recommend a combination of:
- Lab studies including blood, urine and stool tests
- Imaging studies including X-ray, ultrasound, CT or MRI to assess bowel length and function
- Intestinal biopsy
How is intestinal failure treated?
Your child will be cared for by a medical team with experience treating intestinal failure. Treatment is targeted at helping the intestine improve function and may include:
- Medication and nutritional support, both oral and by IV. If your child cannot eat by mouth, treatment may include Total Parenteral Nutrition (TPN), which delivers nutrition through a catheter for a short term.
- Surgery to reshape or lengthen the intestine so it can properly absorb nutrients.
Most patients are successfully treated through medication, nutritional support and surgery that adjusts the small intestine.
For those patients who require intestinal transplantation, over the last several years, success rates for intestinal transplant have improved dramatically. One-year survival rates for patients after intestinal transplants are more than 85 percent, which is comparable to liver transplant patients. Eighty percent of patients who have had an intestinal transplant are able to completely transition from being fed intravenously to an oral diet and resume normal activities of daily living.