Children's Intestinal Rehabilitation Program (ChIRP)
Children's Intestinal Rehabilitation Program (ChIRP)
U-M Health C.S Mott Children’s Hospital has the largest intestinal rehabilitation program in the state. Our team currently provides care to approximately 135 children, including 40 on home total parenteral nutrition, or TPN (nutrition given through a long-term IV).
Our multidisciplinary team provides specialized care individualized to your child. In addition to improving overall outcomes, ongoing parent education and family support are key components of our program.
Our Approach
Our team specializes in the challenges presented by the small, developing bodies of children and includes a:
- Pediatric gastroenterologist
- Pediatric surgeon
- Registered dietitian
- Registered nurse
- Clinical pharmacist
- Clinical social worker
- Program coordinator
Children followed by the ChIRP program also have the benefit of all the resources of C.S. Mott Children’s Hospital. This includes services provided by a team of radiologists accustomed to the diagnostic needs of children with intestinal failure/short bowel syndrome and pediatric anesthesiologists who provide sedation and anesthesia for all invasive procedures. Our team also receives support from child psychiatry and occupational therapy for working with children who have feeding disorders.
Many ChIRP patients have their parenteral and enteral nutrition provided through Michigan Medicine HomeMed Infusion and Specialty Pharmacy. Using HomeMed allows for a streamlined process including both inpatient and outpatient care services, care coordination, and shared medical record documentation.
Who We Treat
Our team cares for newborns to young adults (up to 25 years of age) with any of the following types of intestinal failure and/or surgical diseases that have led to shortened intestinal length. These diseases are characterized by diarrhea, malabsorption, fluid and electrolyte imbalances, and the need for IV nutrition/TPN:
- Congenital malabsorption * Gastroschisis * Hirschsprung’s Disease
- Intestinal atresia or stenosis
- Intestinal dysmotility
- Malrotation
- Necrotizing enterocolitis (NEC)
Services
Testing and assessments done for children with short bowel syndrome or intestinal failure at the Children's Intestinal Rehabilitation Program (ChIRP) include:
- Vital Signs Measurement: Checking height, weight, temperature, pulse, and blood pressure during each clinic visit.
- Specialized Lab Draws: Tests may be necessary to monitor various health parameters, often coordinated with clinic appointments.
- Radiologic Studies: Imaging studies as needed for diagnostic purposes, performed by radiologists accustomed to the needs of children with intestinal failure.
- Medication Administration: This may include administering IV iron or other necessary medications.
- Nutritional Assessment: A complete nutritional evaluation at every clinic appointment, with recommendations for fluid and electrolyte management, tube feedings, special diets, and Total Parenteral Nutrition (TPN) management.
These tests and assessments are carefully coordinated and designed to provide comprehensive care tailored to each child's specific needs.
Treatment options for children with short bowel syndrome or intestinal failure at the Children's Intestinal Rehabilitation Program (ChIRP) at C.S. Mott Children's Hospital include:
- Medical Management:
- Total Parenteral Nutrition (TPN): Nutrition provided through a long-term IV to meet nutritional needs when the intestines cannot absorb nutrients properly.
- Enteral Nutrition: Tube feedings or special diets tailored to the child's needs.
- Fluid and Electrolyte Management: Ensuring proper hydration and balance of electrolytes.
- Medication Management:
- Administration of IV Iron and Other Medications: Any necessary medications coordinated with the child's clinic visits.
- Surgical Options:
- Intestinal Lengthening Procedures: Surgical methods to lengthen the intestine to improve absorption and motility.
- Bacterial Overgrowth Prevention: Surgeries to prevent complications such as bacterial overgrowth.
- Routine Gastrointestinal Surgeries: Including feeding tube placement, anti-reflux procedures, and other necessary gastrointestinal surgeries.
- Nutrition Analysis and Management:
- Nutritional Assessments: Complete nutritional evaluations and recommendations for optimal nutritional care, fluid and electrolyte management, tube feedings, special diets, and TPN management.
- Long-term Nutritional Goals: Aiming to optimize intestinal adaptations and try to wean off TPN whenever feasible.
Appointment Information
For more information, please call 734-232-6825.
To schedule an appointment, start with asking your primary care physician or other specialist for a referral. Providers can fax the ChIRP referral form to 734-998-2398. Our program coordinator will reach out for scheduling after review of referral.
Locations
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Pediatric Intestinal Rehabilitation Program | C. S. Mott Children's Hospital 1540 E Hospital Dr
Floor 8 Reception B
Ann Arbor, MI 48109-4259Get Directions
Doctors
Anushree M Algotar, MBBS
Clinical Assistant Professor
Pediatric Gastroenterology, Pediatrics
Meghan Alexa Arnold, MD
Clinical Associate Professor
Pediatric Surgery, Surgical Critical Care, Surgery
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