Conditions
Intestinal Failure and Short Bowel Syndrome: Conditions We Treat
AIRI cares for patients across California whose intestines cannot absorb enough nutrition, fluid, or electrolytes to maintain health without intravenous support. Our intestinal failure program and intestinal rehabilitation services are built around the conditions below.
This page is written mainly for referring clinicians. Patients and families can find plain-language guides in our Patients and Caregivers library.
Primary indications
Short bowel syndrome and structural loss
Short bowel syndrome develops when surgery or disease leaves too little functioning small intestine to absorb adequate nutrition and fluid. How much bowel remains — and which segments — shapes the risk of intestinal failure and the rehabilitation plan. Common paths to structural loss include:
- Mesenteric ischemia or thrombosis with extensive small bowel resection
- Multiple resections for Crohn's disease leading to short bowel syndrome
- Trauma or oncologic (cancer-related) resections resulting in loss of bowel length
- Enterocutaneous fistula or high-output stoma causing functional short bowel
- Congenital or early-life causes, including short bowel related to necrotizing enterocolitis, intestinal atresia, malrotation or volvulus, gastroschisis, and omphalocele
Motility and neuromuscular disorders
In motility disorders the bowel is intact but its coordinated movement is not, so nutrition cannot be absorbed reliably even though nothing has been resected. These patients often need the same nutrition support and monitoring as those with short bowel. We evaluate and co-manage:
- Chronic intestinal pseudo-obstruction
- Severe intestinal dysmotility not responding to standard therapy
- Hirschsprung disease and related motility disorders
Mucosal and inflammatory disorders
Here the absorptive lining of the intestine is damaged or dysfunctional, producing severe malabsorption despite normal anatomy. Care pairs treatment of the underlying disease with structured nutrition support. Referrals include:
- Complicated Crohn's disease or other inflammatory conditions causing intestinal failure
- Congenital enteropathies and chronic diarrheal disorders, including microvillus inclusion disease, tufting enteropathy, and autoimmune enteropathy
- Radiation enteritis and severe malabsorption
Complications of long-term parenteral nutrition
Patients who depend on total parenteral nutrition (TPN) long term face risks of their own — liver injury, catheter infections, loss of venous access, and metabolic bone disease. AIRI monitors for these complications and acts early, including timely transplant referral when indicated. We manage:
- Intestinal failure–associated liver disease or parenteral nutrition–associated cholestasis
- Recurrent catheter-related bloodstream infection or limited central venous access (see central line care)
- Metabolic complications, including electrolyte disturbance and metabolic bone disease
- Progressive complications that may require intestinal transplant evaluation
Who the program is for
Patients diagnosed with intestinal failure, or at high risk for recurrent intestinal failure — including those who depend on parenteral nutrition long term, and those recently off parenteral nutrition with borderline bowel length or a high-output stoma or fistula.
Patients continuing care from another intestinal rehabilitation program who remain dependent on parenteral nutrition or have significant residual intestinal dysfunction requiring specialized follow-up, including support with home infusion and the move from hospital to home.
When a referral is usually not the right fit
- Patients with adequate intestinal length and absorptive function who can maintain nutrition orally or with standard tube feeding, without parenteral nutrition
- Isolated functional bowel disorders such as irritable bowel syndrome, without structural, motility, or mucosal disease and without intestinal failure
- Patients whose primary need is palliative care for advanced non-intestinal disease — although co-management is available when intestinal failure is also present
Not sure whether a patient fits? Call (209) 929-8260 and ask for the referral coordinator. A brief conversation is often faster than a formal referral.