Intestinal Care Program

The Intestinal Care Program at Seattle Children's Hospital uses the latest treatments to help your child avoid intestine transplant. The program is led by Dr. Simon Horslen, an internationally renowned liver and intestine specialist. Dr. Patrick Javid is the General Surgery leader in the Intestinal Failure Clinic.

What is intestinal rehabilitation (IR)?

Intestinal rehabilitation (IR) is the process of restoring intestinal function through diet, medication and non-transplant surgical therapies.

Who should try IR?

Children who have complex digestive conditions that do not allow them to eat by mouth may be good candidates for IR.

Why is IR used?

A child who cannot eat by mouth must take total parenteral nutrition, or TPN - a complete form of nutrition given intravenously through a central line in the child's chest, neck or groin. TPN is a lifesaver for patients who are unable to absorb adequate nutrition through their small intestine, but if used long-term it can result in liver failure and life-threatening infections.

Our goal with IR therapy is to eliminate or reduce the need for TPN and give patients the physical, emotional and social benefits of eating by mouth.

If intestinal rehabilitation is not successful or is not an option for your child, intestine transplant may be the next step.

What does the Intestinal Care Program do?

Our specialists assess children for intestinal disease, liver problems, dietary management and reconstructive surgical options. If we find that your child will benefit from IR, your child will participate in an intensive program over several months that includes:

  • Detailed evaluation of intestine function
  • Individualized nutrition plan to find the diet that your child's body tolerates best
  • Management of bacterial overgrowth in the intestines
  • Non-transplant surgical treatments, such as intestine lengthening or tapering where needed
  • A gradual weaning from TPN
  • Extensive counseling and education for both patients and families

Depending on an individual child's needs, the initial phase of this program may require a hospital or inpatient stay. This will be followed by regular clinic or outpatient visits. Our goal is to eliminate TPN and prevent the need for intestine transplant whenever possible.

Who's on the team?


Pediatric surgeons


  • Cheryl Davis, RD
  • Melissa Mortensen, RD
  • Nila Williamson, RD

Intestinal failure nurse coordinators

  • Ellen Cella, RN
  • Vicky Kuiper, RN
  • Marsha Larsen, RN

Gastroenterology nurse

  • Doris Taylor, RN

Social worker

  • Maricel Floresca, MSW