Short Bowel Syndrome
Also covered as: intestinal failure · gastroschisis · bacterial overgrowth · necrotizing enterocolitis · midgut volvulus · intestinal atresia · portal hypertension · hepatic steatosis
Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Answers come only from this collection's statement ledger and cite the exact moment · not medical advice
Content of this collection
Foundations
3 items
Necrotizing Enterocolitis with Dr. Gail Besner
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Discussion between Dr. Todd Ponsky and Dr. Gail Besner about necrotizing enterocolitisHistory:Patients will often present with abdominal distention, high gastric residuals and bloody stools.First make sure the problem is in the abdomen.Pat
podcast · 46:29 · Dec 2020
Intestinal rehabilitation: What is intestinal rehab? - Episode 1
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We’re starting a new series about intestinal rehabilitation and all of its intricacies. We’re joined by Drs. Michael Helmrath and Paul Wales, leaders of the Intestinal Rehabilitation Program at Cincinnati Children’s. Hosted by: Todd Ponsky,
video · 14:33 · Dec 2021
Intestinal Rehabilitation, Episode 1: What is intestinal rehabilitation?
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We’re starting a new series about intestinal rehabilitation and all of its intricacies. We’re joined by Drs. Michael Helmrath and Paul Wales, leaders of the Intestinal Rehabilitation Program at Cincinnati Children’s. Hosted by: Todd Ponsky,
podcast · 14:33 · Dec 2021
Surgical Management
1 item
Intestinal Rehabilitation, Episode 4: Surgical Management, Part 1
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We're back with a new topic, discussing surgical management with Drs. Michael Helmrath and Paul Wales from Intestinal Rehabilitation Center at Cincinnati Children's Hospital.
Hosts: Ellen Encisco & Em Tombash
Resources:
Bianchi A.
podcast · 19:07 · Oct 2022
Evidence & Research
4 items
Quick Literature Updates Episode 7
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We’re back with seventh episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review four articles covering the most i
video · May 2023
Disruption of enterohepatic Circulation of Bile acids ameliorates small bowel resection associated hepatic injury
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New article you should know by Cecilia Gigena
"Disruption of enterohepatic Circulation of Bile acids ameliorates small bowel resection associated hepatic injury"
Authors: Maria E. Tecos, Allie E. Steinberger, Jun Guo, Deborah C. Rubi
video · 0:59 · Aug 2023
Outcomes of Children With Short Bowel Syndrome: Experiences in a Multidisciplinary Intestinal Rehabilitation Unit Over Two Decades
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Jaime Tsz-wing Tsang, Adrian Chi-heng Fung , Stephen Cheuk-lam Lau,Kenneth Kak-yuen Wong
Background: Short bowel syndrome (SBS) is a rare but serious form of organ failure, and patients with SBS depend on total parenteral nutrition (PN)
video · 0:45 · Mar 2025
Impact of social determinants of health on outcomes in pediatric short bowel syndrome...
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This video discusses a retrospective cohort study from Cincinnati Children's, presented by Lizzy Lee, examining the impact of social determinants of health on outcomes for children with pediatric short bowel syndrome. The study found that f
video · 0:43 · Aug 2026
In-Depth Reviews
1 item
Intestinal Failure with Dr. Brad Warner
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Discussion with Dr. Brad W. Warner about intestinal failureWhat is intestinal failure?An umbrella term for when the small bowel is unable to digest and absorb an adequate amount of nutrients to sustain a patient through enteral means alone.
podcast · 52:46 · Dec 2020
Long-Term Care
1 item
Care transition from a pediatric intestinal rehabilitation program to adult care and the risk of all-cause mortality: A retrospective cohort study
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Gillian R Goddard, Stephanie Oliveira, Crystal Slaughter, Kim Klotz, Marilyn Stoops, Julie Schletker, Jackie Wessel, Michael Helmrath, Samuel Kocoshis, Monique Goldschmidt, Paul W WalesBackground: As patients with intestinal failure reach a
video · 1:01 · May 2026
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Every statement below comes from the recorded discussions, with its speaker and moment.
Intestinal Rehabilitation, Episode 1: What is intestinal rehabilitation?
Intestinal failure is defined as insufficient gut function to absorb enough nutrients, fluids, and calories to support survival and, in children, growth
clinicalPaul Wales2:05 ↗
For a patient to be defined as having intestinal failure, they must have inadequate intestinal function necessitating parenteral support for at least 60 days
guidelineRod Gerardo2:24 ↗
An intestinal rehabilitation program is a multidisciplinary collaborative patient care paradigm that brings coordinated care for children with intestinal failure through comprehensive management of their specialized nutrition and associated needs
clinicalPaul Wales3:03 ↗
Short bowel syndrome is by far the most common category of intestinal failure in pediatric patients
epidemiologicalPaul Wales4:50 ↗
Causes of short bowel syndrome include congenital anomalies such as intestinal atresia, malrotation, volvulus, gastroschisis, and long segment Hirschsprung's disease
clinicalPaul Wales5:06 ↗
Acquired diseases of the newborn such as necrotizing enterocolitis can cause short bowel syndrome
clinicalPaul Wales5:18 ↗
Motility disorders occur when the bowel is unable to push contents through in a coordinated way due to abnormalities of the muscle itself or the nerves that control that muscle
clinicalPaul Wales5:45 ↗
Congenital enteropathies are conditions where the patient has all of their bowel but the mucosa does not work, leading to hypersecretion and profuse fluid losses
clinicalPaul Wales6:17 ↗
Some patients will have elements of two or three categories of intestinal failure in the way they present
clinicalPaul Wales7:11 ↗
A child with gastroschisis could have short bowel because it was not all viable, inflammation affecting absorption, and motility issues
clinicalEllen Encisco7:22 ↗
Older pediatric patients can develop intestinal failure from inflammatory bowel disease or Crohn's disease where they have lost gut as a result of complications
clinicalPaul Wales7:56 ↗
Trauma, malignancy, and vascular thrombosis leading to gut loss are diagnoses seen more in older patients or adult series and less in pediatrics
epidemiologicalPaul Wales8:04 ↗
There are three time points where families reach intestinal rehabilitation programs: prenatal diagnosis, postnatal acquired problems, and later presentations after discharge
clinicalMichael Helmrath8:53 ↗
Prenatal diagnoses that lead to intestinal rehabilitation typically include atresia with cystic fibrosis and gastroschisis
clinicalMichael Helmrath9:15 ↗
Postnatal acquired problems leading to intestinal rehabilitation include volvulus and necrotizing enterocolitis
clinicalEllen Encisco9:29 ↗
Dietitians play a key role in understanding the nutritional needs of children in intestinal rehabilitation
opinionMichael Helmrath11:52 ↗
Social work is a key component of the intestinal rehabilitation team
opinionMichael Helmrath12:01 ↗
The survival overall in big intestinal rehabilitation programs is usually over 90% long-term survival
epidemiologicalRod Gerardo12:34 ↗
Children with intestinal failure who survive long-term now develop chronic comorbidities including renal dysfunction, metabolic bone disease, neurocognitive issues, and quality of life issues
clinicalPaul Wales12:46 ↗
Earlier recognition and taking advantage of the biology of the gut to adapt are time dependent
clinicalMichael Helmrath2:40 ↗
Intestinal rehabilitation streamlines care and improves communication with families and between care providers and team members
opinionPaul Wales3:55 ↗
Intestinal rehabilitation comes down to key factors that drive the process: nutrition in the gut, nutrition in the body, and healing
clinicalMichael Helmrath4:07 ↗
Pattern recognition from multiple eyes on a baby who have seen them over time is important in intestinal rehabilitation
opinionMichael Helmrath4:19 ↗
Intestinal Rehabilitation, Episode 4: Surgical Management, Part 1
Adrian Bianchi first reported the longitudinal intestinal lengthening procedure (Bianchi procedure) that divides bowel along its two leaves and tubularizes it
clinicalMichael Helmrath1:23 ↗
In the 1980s and 1990s, babies with intestinal failure had poor outcomes primarily due to liver progression to inflammation and fibrosis associated with parenteral nutrition, lipids, and phytosterols
epidemiologicalEllen Encisco1:50 ↗
Rising direct bilirubin was recognized as a sign that children with intestinal failure would not do well
clinicalMichael Helmrath2:13 ↗
The first 4 months of life is when care for intestinal failure patients is most uncoordinated and surgical decisions have the most profound effect on long-term outcome
clinicalEm Tombash2:29 ↗
The gut doubles in length during the last trimester and the first year of life
clinicalMichael Helmrath2:55 ↗
Intestinal maturation occurs when the baby is fed; healthy growth of the intestine requires nutrition
clinicalMichael Helmrath2:58 ↗
Disrupting the feeding and maturation process affects not only the intestine's ability to absorb and digest but also peristalsis and function
clinicalMichael Helmrath3:06 ↗