Pediatric intestinal failure

What does pediatric intestinal failure mean?

The small intestine is the part of the digestive tract responsible for nutrient absorption. Intestinal failure occurs when the intestine does not function well enough to absorb nutrients, vitamins, and water from food. Intestinal failure can affect a child’s growth and development.

What are the signs and symptoms of pediatric intestinal failure?

Symptoms of intestinal failure will depend on the underlying cause.

• Abdominal pain

• Bloating

• Constipation

• Diarrhea

• Heartburn

• Impaired growth and development

• Nausea or vomiting

• Pale appearance

• Poor appetite

• Weight loss or poor weight gain

• Weakness and fatigue

How is pediatric intestinal failure diagnosed?

To diagnose intestinal failure, your child’s doctor will do a complete physical exam of your child and ask you about past medical events. Your child’s doctor may also recommend diagnostic testing, including:

• Blood, urine and stool tests

• Pediatric ultrasound (sonogram)

• Pediatric computer tomography (CT)

What causes pediatric intestinal failure?

The most common cause of intestinal failure is short bowel syndrome (short gut), which is usually the result of injury or damage to the intestine. When a child has a shortened bowel, food passes too quickly or slowly for the small intestine to do its job properly. This can cause dehydration, malnourishment and bacterial infections.

• Shorter-than-normal intestine at birth

• Intestinal surgery

• Hirschsprung's disease

• Intestinal atresia

• Gastroschisis

• Congenital diarrheal disorders (CDD)

• Autoimmune bowel disease

• Malabsorption

• Crohn’s disease

• Volvulus

• Necrotizing enterocolitis

How is pediatric intestinal failure treated?

Children with intestinal failure need support getting the essential nutrients their digestive system can’t absorb. In addition to improving your child’s nutrition, treatment is targeted at helping improve intestine function.

• Medication - Certain medicines can help stimulate the digestive tract to move faster and more efficiently

• Nutritional support - A feeding tube may help your child get the nutrition they need. However, if your child cannot eat by mouth, total parenteral nutrition (TPN) can be used instead, delivering nutrition into the bloodstream through an IV.

• Surgery - Procedures to reshape or lengthen the intestine can improve the digestive system's ability to absorb nutrients properly.

• Intestinal rehabilitation - Some children can wean off TPN. Intestinal rehabilitation aims to help your child’s intestine work better with diet, medicine and surgery (not including transplants). Intestinal rehabilitation can significantly reduce the need for intestinal transplants.

• Transplant - Some children may need transplants to get the nutrition they need. Eighty percent of patients who have had an intestinal transplant can completely transition from being fed intravenously to an oral diet and resume normal activities of daily living.