Intestinal Rehabilitation

Intestinal Failure
Evaluation
Treatment

Intestinal Failure

Intestinal failure occurs when your intestines can't digest food and absorb the fluids, electrolytes and nutrients essential to live. Intestinal failure is most often caused by short bowel syndrome, a problem that affects people who have had half or more of their small intestine removed due to injury or surgery to treat conditions such as trauma or mesenteric artery thrombosis. Intestinal failure also may be caused by digestive disorders, such as Crohn's disease or chronic idiopathic intestinal pseudoobstruction syndrome, which causes the bowel to malfunction.

If you have intestinal failure, you may receive all or most of your nutrients and calories intravenously through total parenteral nutrition (TPN). TPN is given through a catheter placed in the arm, groin, neck or chest. Patients on TPN may live for many years, but long-term use of TPN can result in serious complications, such as bone disorders, central venous catheter infections and liver disease. Our goal is to restore intestinal function to minimize and ultimately eliminate the need for TPN. Unfortunately, not every patient can be weaned from TPN. In these cases, we work to optimize the use of TPN and decrease the risk of complications.

Conditions

Patients who may benefit from being treated at the Intestinal Rehabilitation and Transplantation Program include:

• Adults with intestinal failure caused by:

  • Desmoid tumor, a benign growth of tissue that can develop in the abdomen
  • Fistulae or an abnormal duct that connects an abscess, cavity or hollow organ to the body surface or to another hollow organ
  • Inflammatory bowel disease, such as Crohn's disease where chronic inflammation occurs in the intestines
  • Multiple intestinal surgeries resulting in adhesions, motility problems that may lead to abnormal intestinal contractions and spasms
  • Pseudoobstruction that impairs gastrointestinal motility despite the absence of an actual obstruction
  • Radiation enteritis, a disorder of the large and small bowel that occurs during or after a course of radiation therapy to the abdomen, pelvis or rectum
  • Refractory celiac disease, also known as sprue, a digestive disease that damages the small intestine and interferes with absorption of nutrients from food
  • Superior mesenteric artery/vein thrombosis
  • Trauma
  • Tumor resection
  • Volvulus or an abnormal rotation of the intestine

• Children with intestinal failure caused by:

  • Aganglionosis, also known as Hirshsprung's, a deformity of the bowel where the nerves are missing
  • Diseases of the intestinal surface, such as congenital villous atrophy or microvillus inclusion disease
  • Gastroschisis, a congenital defect of the abdominal wall
  • Intestinal atresia a blockage or obstruction in the intestine
  • Midgut volvulus
  • Multiple intestinal surgeries resulting in adhesions and problems with motility and/or absorption
  • Necrotizing enterocolitis, a serious disorder affecting a baby's gastrointestinal tract
  • Pseudoobstruction and other motility disorders
  • Short bowel syndrome

Reviewed by health care specialists at UCSF Medical Center.
Last updated February 14, 2008