Pediatric Intestinal Rehabilitation Program
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Intestinal failure is a life-threatening condition that occurs when a child’s small intestine is unable to absorb the nutrients needed to grow and thrive. This can be due to a congenital (at birth) defect or to an illness that has led to damage or removal of part of the intestine.
Care for children with intestinal failure requires the expertise of an experienced and multidisciplinary team. At the Pediatric Intestinal Rehabilitation Center (PIRC), located in NewYork-Presbyterian Morgan Stanley Children’s Hospital, your child has access to specialists at one of the top medical centers in the country. Our team includes experts from pediatric gastroenterology, hepatology, surgery, infectious disease, neonatology, nutrition, feeding and occupational therapy, radiology, pathology, and social work.
Whether your child is transitioning out of the neonatal intensive care unit or has been referred to our program by your pediatrician or specialist, your child will be treated and monitored in our dedicated intestinal rehabilitation center by a pediatric gastroenterologist, pediatric surgeon, nurse practitioner, registered dietician, and social worker. Together, we create a comprehensive plan of care tailored to your child’s specific needs.
Your child’s treatment may include medications, parenteral nutrition, enteral nutrition, and surgery. We work closely with parents, family and other members of the care team to manage your child’s treatment and ensure that you have the support you need at home.
Our Approach to Intestinal Rehabilitation
Treatment of intestinal failure promotes your child’s growth and health while rehabilitating the intestine. Intestinal rehabilitation involves therapies designed to improve bowel function through a combination of nutritional support, medication, and restorative surgery. Many children transition to oral feeding through our comprehensive treatment program.
Nutritional Support
We combine enteral nutrition (feeding the intestine directly via feeding tube or mouth) and parenteral nutrition (fluid, calories, and nutrients through a catheter placed in a vein) to provide your child with nutrients and energy to support growth and development. All patients undergo a complete nutritional evaluation by a registered dietitian. Your child’s gastroenterologist and dietician will work closely with you to create an individualized nutrition plan for your child and advance your child’s ability to take enteral feeds. We also provide feeding and occupational therapy to encourage your child to eat by mouth.
Medical Management
A variety of medications slow down the movement of the intestine and help your child absorb food. We combine these to suit your child’s unique needs.
Surgical Evaluation and Treatment
Your child’s pediatric surgeon will participate in your child’s team visits and will consider possible restorative surgeries that reshape the intestine to make it more functional. NewYork-Presbyterian Morgan Stanley Children’s Hospital is one of a few hospitals in the country to offer the serial transverse enteroplasty procedure (STEP), in which the small intestine is surgically reshaped to increase surface area and lengthen the amount of time it takes for food to move through it, increasing absorption of nutrients.
Transplantation
We offer intestinal and multi-visceral organ transplantation to children when other treatment strategies have failed. Specialists at New York-Presbyterian Morgan Stanley Children’s Hospital perform isolated small intestine transplantation in children with intestinal failure who have a functioning liver and offer combined liver and intestinal transplantation for patients with both liver and intestinal failure.
Family Support
We provide family support and ongoing education. Our social worker will work closely with you and your child to assist in arranging school accommodations, nursing, transportation, supplies and travel (nationally and internationally). We have an annual PIRC Family Night, which provides families an opportunity to meet each other and our team in a more informal setting.
Improved Protocols for Better Patient Outcomes
Our team follows special protocols designed to improve outcomes and enhance your child’s quality of life. Our central line-associated bloodstream infection rate is consistently below the national average and we utilize ethanol lock therapy and ongoing caregiver education to further minimize risk for central line infections. We also use a range of parenteral lipid solutions (i.e., SMOFlipids and Omegaven) to prevent TPN-associated liver injury.
Conditions We Treat
Our expert team cares for patients with intestinal failure caused by:
- Necrotizing enterocolitis
- Congenital intestinal atresia
- Congenital diarrheal disorders
- Gastroschisis
- Volvulus
- Motility disorders
- Hirschsprung disease
