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Intestinal Rehabilitation Programs in the Management of Pediatric Intestinal Failure and Short Bowel Syndrome
Russell J Merritt1, Valeria Cohran, Bram P Raphael
1*Pediatric Gastroenterology, Hepatology and Nutrition, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA †Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL ‡Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Harvard Medical School, Boston, MA §Section of Pediatric Gastroenterology, Hepatology & Nutrition, University of Chicago, Chicago, IL ||Icahn School of Medicine, Valley Health System, Ridgewood, NJ ¶Washington University School of Medicine #St Louis Children's Hospital, One Children's Place, St Louis, MO **Medical College of Wisconsin, Milwaukee, WI.
Insights
Intestinal failure requires specialized care, best provided by intestinal rehabilitation programs. These multidisciplinary teams aim for patients to achieve oral feeding, improving outcomes and quality of life.
Area of Science:
- Gastroenterology and Hepatology
- Pediatric Surgery
- Clinical Nutrition
Background:
- Intestinal failure is a rare, severe condition with complex acute and chronic management needs.
- Life-threatening without specialized, individualized medical therapy including surgery, nutrition, and nursing.
- Intestinal rehabilitation programs offer a structured approach to managing this condition.
Purpose of the Study:
- To highlight the critical role of intestinal rehabilitation programs in managing intestinal failure.
- To emphasize the multidisciplinary approach required for optimal patient outcomes.
- To underscore the benefits of integrated care for patients with intestinal failure.
Main Methods:
- Multidisciplinary team approach involving pediatric surgeons, gastroenterologists, nurses, and dietitians.
- Integrated care encompassing medical management, nutritional support, and patient education.
- Focus on achieving enteral autonomy and oral feeding, with consideration for intestinal transplantation.
Main Results:
- Intestinal rehabilitation programs provide integrated, interdisciplinary care, enhancing patient management.
- These programs improve continuity of care, outpatient follow-up, and patient/family education.
- They facilitate earlier complication treatment and leverage accumulated patient data for quality assurance and research.
Conclusions:
- Multidisciplinary intestinal rehabilitation programs are essential for ameliorating the impact of intestinal failure.
- Coordinated care by various health professionals significantly improves health outcomes and quality of life.
- These programs are crucial for achieving enteral autonomy and enabling oral feeding in affected individuals.
Abstract:
Intestinal failure is a rare, debilitating condition that presents both acute and chronic medical management challenges. The condition is incompatible with life in the absence of the safe application of specialized and individualized medical therapy that includes surgery, medical equipment, nutritional products, and standard nursing care. Intestinal rehabilitation programs are best suited to provide such complex care with the goal of achieving enteral autonomy and oral feeding with or without intestinal transplantation. These programs almost all include pediatric surgeons, pediatric gastroenterologists, specialized nurses, and dietitians; many also include a variety of other medical and allied medical specialists. Intestinal rehabilitation programs provide integrated interdisciplinary care, more discussion of patient management by involved specialists, continuity of care through various treatment interventions, close follow-up of outpatients, improved patient and family education, earlier treatment of complications, and learning from the accumulated patient databases. Quality assurance and research collaboration among centers are also goals of many of these programs. The combined and coordinated talents and skills of multiple types of health care practitioners have the potential to ameliorate the impact of intestinal failure and improve health outcomes and quality of life.
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