Digestive and Gastrointestinal Conditions

Short Bowel Syndrome Treatment


Seattle Children’s is home to the Pacific Northwest’s only pediatric Intestinal Rehabilitation Program. Our doctors have special training in treating short bowel syndrome (SBS) and in helping children with SBS get the nutrition they need. When a child needs an operation, our general and thoracic surgery team includes experts in the procedures that can help overcome SBS. Studies show that children with this condition do better in specialized pediatric clinics like ours.

Doctors from many states refer children with SBS here for treatment, and our doctors work closely with those providers. That means some patients with SBS can come to Seattle Children’s for only one visit. Then we can partner with your child’s local doctor to guide their care at home.

Short Bowel Syndrome Treatments

Feeding assistance

Many children with SBS need extra nutrients through a tube that goes into a vein (intravenous, or IV, feeding). This is called intravenous nutrition (total parenteral nutrition, or TPN). TPN is a long-term treatment for some children. Doctors often work to wean children off TPN when possible. This helps children lead a more normal lifestyle and can prevent complications such as liver problems and bacterial infections.

Another important part of feeding is giving your child some food by mouth. This helps your child learn how to suck and eat, and helps them absorb food. Our dietitians and therapists are specially trained to teach your child these skills.

Intestinal rehabilitation

Intestinal rehabilitation tries to get your child’s small bowel working again with diet, medicines and, in some cases, surgery. This form of rehabilitation is our Intestinal Care Program’s main focus. Your team includes doctors who specialize in the stomach and intestines (gastroenterologists), liver doctors (hepatologists), pediatric surgeons, nurses, nutritionists, social workers, pharmacists and others — many with advanced training in SBS.

Medicines and hormones

Medicines are used in children with SBS to:

  • Reduce stomach acid
  • Slow food’s movement through the bowel
  • Decrease diarrhea
  • Help children absorb more nutrients
  • Control bowel bacteria

Hormones may be used to help the bowel lining (mucosa) grow, which helps it absorb more nutrients.


Surgery may be used in children with SBS to taper or to lengthen the small bowel.

  • In children with SBS, part of the small bowel may become enlarged (dilated). Fluid and bacteria can collect in this area. This can lead to infections and can keep nutrients from being absorbed. The enlarged bowel may not move as well. “Intestinal tapering” is when surgeons operate to make this area smaller.
  • Some children with SBS have enough small bowel that surgeons can lengthen it and restore function. The surgery we use is called STEP (serial transverse enteroplasty). The surgeon cuts notches in both sides of an enlarged segment of bowel and sews along the cut edges. This creates a zigzag shape that makes the bowel narrower and longer than the dilated bowel. This means that food will take longer to move through the bowel and will touch the bowel lining for a longer period. This allows the child’s body to digest food better and create less stool.

Seattle Children’s is one of just a handful of hospitals that perform this surgery several times each year.


If intestinal rehabilitation is not an option for your child or doesn’t help them enough, an intestine transplant may be the next step.

Our Intestine Clinic’s doctors helped lead the way in intestine transplant surgery. This has become the best option for treating children with permanent intestinal failure.

Our intestine transplant team is led by 2 internationally recognized doctors: Dr. Simon Horslen, a pediatric liver and intestine specialist (or hepatologist), and Dr. Jorge Reyes, a surgeon who has performed 200 multiorgan transplantations in children. Drs. Horslen and Reyes have provided care for more children with intestinal failure than most other doctors in the nation.

Studying New Treatments for Short Bowel Syndrome

Our doctors and researchers are involved in clinical trials to develop and study new treatments. The goals are to improve how we overcome intestinal failure and to make intestinal surgery and transplants better. Some of our patients can participate in these studies and get the newest treatments before they are widely available.

Your child’s doctor will talk with you in detail about any new treatment that might help your child.

Contact Us

To learn more about short bowel syndrome treatment at Seattle Children’s, call our Gastroenterology and Hepatology Clinic at 206-987-2521.