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
Treatments:
The Intestinal Rehabilitation and Transplantation Program offers a wide range services for adults and children. The type and length of treatment differs for each patient, depending on the needs and goals.
Services include:
- Counseling and education about intestinal rehabilitation
- Drug and diet modification to train the small intestine to absorb more nutrients
- Consultations to help assess and correct nutrient deficiencies and prevent damage to kidneys, bones and liver
- Management of TPN to avoid complications
- Placement and management of catheters in veins called central venous lines
- Surgery, such as bowel lengthening and tapering that can help increase bowel length and nutrient absorption
- Intestinal transplants
- Consultations with doctors caring for patients with intestinal failure
For patients dependent on TPN, the program provides services to help patients:
- Reduce or eliminate the need for TPN
- Reduce complications associated with TPN
- Decrease diarrhea and/or vomiting
- Gain weight
- Decrease the need for intestinal transplantation
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