Intestinal Rehabilitation for Children

For Intestinal Failure, Short Bowel Syndrome, and Other Intestinal Diseases

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Children who experience intestinal failure because of short bowel syndrome, intestinal dysmotility, congenital disorders, or surgical complications may benefit from intestinal rehabilitation. This process focuses on your child’s nutritional care to maximize intestinal function. Duke is one of the few intestinal rehabilitation centers in the region with a team of specialists experienced in providing intestinal rehabilitation through diet, medications, and nonsurgical and surgical procedures.

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Intestinal Rehabilitation Evaluation

The evaluation begins when we consult with your child’s referring doctor and review the data they have collected on your child’s condition. We will also request and review notes from any gastrointestinal (GI) surgeries your child may have had.

Your child will undergo an extensive evaluation and nutritional analysis with all members of our intestinal rehabilitation team to determine what type of intestinal rehabilitation method is best for them. The evaluation may take several days or appointments, depending on what tests and screenings are needed. It may include blood tests, X-rays or other imaging studies, and diagnostic procedures. After we have completed this testing, the intestinal rehabilitation team will tailor our recommendations to your child’s individual needs.

The goals of intestinal rehabilitation for your child include increasing weight gain and linear growth, decreasing stool output, improving hydration, and improving nutrient deficiencies. This may allow your child to be weaned off total parenteral nutrition (TPN).  

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.


Nonsurgical Options

Our experts may recommend antibiotic therapy, dietary modifications including tube feeding, changes to total parenteral nutrition content, teduglutide (Gattex) injections, and other therapies designed to improve intestinal function to help wean your child off TPN. Children undergoing intestinal rehabilitation often require the placement and use of feeding tubes.

Nontransplant Surgical Options

Surgery may be recommended if medical management is no longer effective in your child’s rehabilitation. Options include:

  • Serial transverse enteroplasty (STEP): Lengthens the small intestine. This can lead to increased fluid and nutrition absorption.
  • Longitudinal intestinal lengthening and tailoring procedure: Increases the length of the bowel to support better nutrition absorption.

Intestinal Transplant

For some conditions, intestinal transplantation may be needed. Duke is among a small number of U.S. hospitals with experienced transplant surgeons who perform intestinal transplants on children.

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Family-Friendly Services

We understand that your child’s intestinal disorder can take an emotional toll on your child and your family. Our team meets with you to explain your child’s condition and answer any questions you may have. We do everything we can to make sure you and your child understand and are comfortable with every phase of treatment. This includes providing you with information, reassurance, support, and compassion.

Child Life Specialists

Hospitalization can be scary for anyone. Our Child and Adolescent Life staff are trained in child development and family-centered care. They help your child cope -- through play, preparation, education, and self-expressive activities. An activity room offers everything from lively video games, books, and board games to the joys of simply sharing a conversation or a smile. Teachers are available to provide continued learning and education during your child’s hospital stay.

Care Coordination and Support

Our social workers can help you navigate the medical system and coordinate the variety of health services your child needs. We help you work with insurance providers, connect with resources, and manage details related to your child’s care.

Best Children's Hospital in NC

Duke Children's Hospital & Health Center is proud to be nationally ranked in 10 pediatric specialties.

Your Child's Intestinal Rehabilitation Team

A Team of Experts
The intestinal rehabilitation team at Duke includes gastroenterologists, surgeons, nurse coordinators, registered dietitians, nurse practitioners, social workers, and pharmacists. Your child may also receive care from experts in occupational therapy, speech therapy, and child psychiatry.

Treatment from Birth to Adulthood
We treat infants to to children 18 years of age, and can assist with the transition to adult care.

Convenient Care 
Although many of our patients live in the Carolinas, we provide services to children from across the U.S. No matter where you live, we help you schedule your child's appointments to be as convenient as possible. If you live in or near Durham, it may work best to schedule your child's treatment over time. If you live far away, we'll try to condense your child's appointments into the shortest number of days their treatment will allow.

Access to the Latest Research and Treatments
Our role in intestinal rehabilitation research and education means your child benefits from the latest advances in treatment. For example, they may be eligible to participate in pediatric trials for medications that are used to improve intestinal absorption.

Leaders in National Intestinal Rehabilitation and Transplant Organizations
Our intestinal rehabilitation experts hold leadership positions in national intestinal rehabilitation and transplant organizations, including the United Network for Organ Sharing (UNOS).

This page was medically reviewed on 11/08/2023 by