From the Experts: Intestinal Rehabilitation Program Improves Young Lives

The Hasbro Children’s Intestinal Rehabilitation program offers a multidisciplinary approach to medical, nutritional and surgical treatments for infants, children, and adolescents who are unable to use their gastrointestinal tract to obtain nutrients for survival. It is a collaboration between the pediatric disciplines of gastroenterology, nutrition, surgery, rehabilitation (occupational and speech therapists), pharmacy, nursing, child life, and social work. 

Patients requiring intestinal rehabilitation have intestinal failure from a variety of causes and are managed in a comprehensive, evidence-based, and family-centered approach. 

Carolina Cerezo, MD, and Christine Andrews, MD, MPH, Answer Questions About the Intestinal Rehabilitation Program

How Does an Intestinal Rehab Program Work?

The aim of the program is to improve and restore the digestive and absorptive function of the gastrointestinal tract. Our specific goals include:

  • Nutrition support: Deliver adequate nutrition through parenteral methods (TPN, PPN) using central venous access, or via enteral routes such as feeding tubes.
  • Adaptation: Help the intestine to adapt to its new role or restore function after an injury, by enhancing the repair, growth, and development of the injured or remaining bowel.
  • Medical management: Address the medical complications resulting from intestinal failure such as malabsorption and nutrient deficiencies.
  • Surgical management: Identify and address the presence of a surgical condition that prevents intestinal adaptation or rehabilitation and perform surgery that may improve function of the remaining bowel. 

What Are the Most Common Conditions We Treat?     

Structural Intestinal Failure

The most common cause of intestinal failure is short bowel syndrome (SBS). SBS may result from necrotizing enterocolitis, Hirschsprung’s disease, congenital anomalies such as gastroschisis, bowel atresia, mid-gut volvulus from malrotation, omphalocoele, trauma, inflammatory bowel disease or tumors. 

Functional Intestinal Failure

When the intestine is unable to digest and absorb nutrients, it is known as functional intestinal failure. Although the anatomy is intact, full function is lost. Common causes are:

  • Intestinal pseudo-obstruction
  • Intestinal dysmotility
  • Congenital diarrhea syndrome (microvillous inclusion disease, Tufting enteropathy, congenital sodium/chloride diarrhea)
  • Mitochondrial and other genetic disorders
  • Radiation enteritis

Many young patients may be temporarily or permanently dependent on parenteral or enteral nutrition for health. They often have complex medical and surgical histories and require close follow-ups which include regular laboratory tests and imaging studies. For those with central venous catheter, the risk for catheter and blood-related infection is high and increases the chances of emergency room visits and hospital admissions. Many may have associated developmental and behavioral impairments, which lowers their quality of life compared to their peers. 

Meet Our Team

The Hasbro Children’s Intestinal Rehabilitation Program team includes:

We provide consultation, treatment and long-term follow up for patients in the outpatient, inpatient general pediatric unit, and neonatal and pediatric intensive care units. To make a referral, call the pediatric gastroenterology, nutrition and liver disease office at 401-444-4917 or fax to 401-444-8748.

Pediatric Gastroenterology, Nutrition and Liver Diseases