Intestinal Failure

Normally, the small intestine absorbs most of the water and nutrients in the foods we eat. Sometimes the small intestine does not work properly due to injury or disease or because part has been removed to treat another problem, such as gastroschisis. In these cases, a child may not have enough functioning small intestine to absorb the nutrition they need.

Many diseases and conditions can lead to intestinal failure in children.

The most common cause is short bowel syndrome (SBS). Children with SBS have had at least half of their small intestine removed to treat an injury, a disease or another intestinal problem. How severe SBS is depends on how much of your child’s small intestine still works.

There are two treatments for intestinal failure. One involves getting a complete form of nutrition through a central line. This is called total parenteral nutrition (TPN). Another is restoring the intestine’s function through intestinal rehabilitation.

Some children need a third option, an intestine transplant, but advances in intestinal rehabilitation have greatly reduced the need for organ transplants.

Children with intestinal failure cannot absorb nutrients from the food they eat, so they must get nutrition another way. We use total parenteral nutrition (TPN).

TPN is a mixture containing nutrients given directly into your child’s bloodstream. The nutrients go through a tiny tube (catheter) placed in a central vein (intravenously, or by IV). Sometimes TPN is a long-term or even permanent solution for intestinal failure. The chances of problems due to the need for TPN tend to increase over time.

Some children can be slowly taken off TPN with a treatment option called intestinal rehabilitation. With intestinal rehabilitation, healthcare providers help your child’s intestine work better through diet, medicine and surgeries that do not include transplant.

We have greatly reduced the need for intestine transplants using intestinal rehabilitation. Learn more about our Intestinal Rehabilitation Program.

If you and your child’s medical team decide an intestine transplant is the best option for your child, our team will support you and your family throughout the process. 

Dr. Eveyln Hsu, the medical director of Liver and Intestine Transplant at Seattle Children’s, is a world-renowned experts in the field of intestinal and liver failure. Hsu has many years of experience treating children with complex digestive problems. 

Dr. Patrick Javid is a pediatric general surgeon with a clinical specialty in intestinal failure. He is active in clinical research focusing on infants and young children with intestinal failure. Javid performs bowel-lengthening surgeries, including serial transverse enteroplasty (STEP).

We are committed to excellent results. We are always seeking to improve our transplant and nontransplant surgery techniques. We continue to innovate as well with diet and medicines so we can provide the most current treatments and the very best care for your child.

Our Intestinal Rehabilitation Program and Intestine Transplant Program include education and support for you and your child from compassionate experts who understand your family’s needs.

Our top research priority is finding ways to avoid the need for transplantation in infants with intestinal failure. We continue to advance the practice and understanding of transplants through our research programs.