Valeria Cohran, MD, highlights specialist-pediatrician collaboration when treating short bowel syndrome-associated intestinal failure

At the 2025 North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN), Valeria C. Cohran, MD, Medical Director, Intestinal Rehabilitation and Transplantation; Attending Physician, Gastroenterology; Professor of Pediatrics, Northwestern University Feinberg School of Medicine, spoke about the importance of subspecialist-pediatrician collaboration in managing children with short bowel syndrome-associated intestinal failure (SBS-IF). The discussion was in the context of her abstract Characteristics Associated With Response to Teduglutide Treatment in Children With Short Bowel Syndrome–Associated Intestinal Failure: A Post Hoc Analysis of Long-Term Extension Studies.

Cohran emphasized the dual care needs of these patients. “It’s very important — whether it’s vaccines, preventative care, sleep training, or toilet training…as a subspecialist, I don’t have the expertise with that as I used to when that’s all that I did. So I think it’s very important for the pediatrician to recognize that they are our partners in this,” she said.

She encouraged pediatricians to reach out to specialized centers for support, noting that some patients may have limited local resources. “If you have a patient that has intestinal failure, who’s on TPN, who may not be doing well — know that there are centers of excellence, like intestinal rehab programs, that take care of these patients,” she explained. Cohran highlighted telehealth as a valuable tool for extending subspecialist expertise.

Cohran also outlined the structure of intestinal rehabilitation programs, which include multidisciplinary teams composed of a pediatrician, surgeon, nurses, and dietitians. “When I say the term ‘intestinal rehab program,’ these are multidisciplinary programs that have, at minimum, a pediatrician, a surgeon — whether that’s a transplant surgeon or pediatric surgeon — as well as nurses and dietitians. Those are really the basics that NASPGHAN outlined when we published our position paper,” she said.

She stressed that collaboration does not mean taking over care entirely. “We work with local GI physicians also. So it’s not necessarily that we take over all of the care, but we definitely can work with other general pediatricians and pediatric GIs who may not have an intestinal rehab program,” Cohran said.

Finally, she noted that some families seek access to therapies like teduglutide at specialized centers. “Not everybody feels comfortable, for instance, using teduglutide, and so we may have patients that get transitioned to us…because their local pediatric gastroenterologist doesn’t feel as comfortable with it,” she added.

Cohran concluded by highlighting that partnership and open communication between subspecialists and pediatricians are vital to optimize outcomes and support families caring for children with SBS-IF.

Reference:

Cohran V, et al. CHARACTERISTICS ASSOCIATED WITH RESPONSE TO TEDUGLUTIDE TREATMENT IN CHILDREN WITH SHORT BOWEL SYNDROME-ASSOCIATED INTESTINAL FAILURE: A POST HOC ANALYSIS OF LONG-TERM EXTENSION STUDIES. Abstract. Presented at: 2025 NASPGHAN Annual Meeting. November 5-9, 2025. Chicago, Illinois.