Intestinal Failure

We specialize in helping you rehabilitate your or your child's intestine when the small bowel fails to ingest, digest, or absorb nutrients, water and electrolytes, an ailment called intestinal failure.

We have experience with many of the rarest cases of intestinal failure from around the world. We're pleased to say have been able to help hundreds of children and adults go on to live normal lives. Our expertise has helped many patients avoid intestinal transplant surgery. 

 

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Patient Guides

Intestinal failure (IF) results from:

  • A blockage in the intestine
  • The Inability of the intestinal track to move food through the intestine
  • Surgical procedures that result in partial or complete loss of the small intestine
  • Congenital defects that cause loss of the small intestine
  • Congenital defects that cause the small intestine not to absorb fluid or nutrition

Types of Intestinal Failure We Treat:

Structural Intestinal failure - often called short-bowel syndrome (SBS). Often caused due to surgery to remedy:

  • Gastroschisis
  • Intestinal Atresia
  • Mid-gut Volvulus / Bowel Malrotation
  • Necrotizing Enterocolitis (NEC)
  • Omphalocele
  • Trauma to the Abdomen
  • Crohn's Disease
  • Superior Mesenteric Thrombosis
  • Tumors

Functional intestinal failure - caused by the intestine's inability to absorb or digest food or fluids. In this case length isn't the problem, just that the intestine isn't working right, typically because of:

  • Chronic Intestinal Pseudo-obstruction (CIPS)
  • Enterocutaneouse Fistula
  • Hirschsprung's Disease
  • Intestinal Dysmotility
  • Total Colonic Aganglionosis
  • Microvillous Inclusion Disease
  • Tufting Enteropathy
  • Radiation Enteritis

Treatment Options

At Nebraska Medicine, we offer a comprehensive Intestinal Failure program with medical and surgical treatment options, including:

  • Comprehensive medical care for adult and pediatric patients with complex liver and intestinal diseases.
  • A multidisciplinary intestinal rehabilitation program for patients on total parenteral nutrition (TPN), focusing on decreasing their need for TPN with the goal of preventing or delaying the need for transplantation.
  • Nutritional support.
  • Omegavan trials for infants. The calorie-dense lipids in total parenteral nutrition (TPN) help keep the intestinal failure patients alive, but the type used in the United States (made from soybean oil) contains a high amount of Omega-6 fatty acids, which can lead to cirrhosis of the liver. Omegaven, a lipid preparation made from fish oil could be far less toxic to patients' livers than TPN. Omegaven is only currently available in Europe, except in the case of studies like the one at Nebraska Medicine or under special release from the FDA.
  • Surgical treatment options, including lengthening procedures such as STEP (Serial Transverse Enteroplasty), tapering procedures, repair of fistulas and bowel reconnection.
  • Transplantation, including isolated intestinal transplant and liver/intestine/pancreas (multivisceral) transplantation, when medical or surgical treatment interventions fail.

How We Care For Our Patients

Many patients and their families arrive at Nebraska Medicine prepared for the worst. They often come from places where their doctors have never seen another patient with a condition like theirs. At Nebraska Medicine, we offer hope because helping patients with intestinal failure is what we do.

When you arrive at Nebraska Medicine, our team will do the necessary testing, explore available treatment options, and move forward. We encourage our patients to expect the best. We provide the best care possible, and will work to get them home and living life again.

Specialists on our intestinal failure team have expertise in hepatology, gastroenterology, psychology, child life and surgery for both adult and pediatric patients. Our doctors are not afraid to get down on the floor and play with their pediatric patients, treating them like the children they are.

Everyone on our team, from specially-trained transplant nurse coordinators, social workers and nutritionists to pharmacologists, patient financial counselors and volunteers, is working towards the same outcome.

At Nebraska Medicine, we provide the most comprehensive outpatient and follow-up care in the country, helping our outcomes and survival rates exceed national averages. Our intestinal failure team provides patients and their families with extensive support and education throughout the transplant journey, and even after they return home.