Overview

Overview

Intestinal Rehabilitation works as an integrated part of the Center for Gut Rehabilitation and Transplantation. The goal is to improve the function of any remaining bowel, so that a patient can return to a more normal life. The staff accomplish this with intensive nutrition counseling, oral rehydration solutions, techniques using enteral feeding, medications, growth factors, and, if necessary, restorative surgery including transplantation.

The Center is one of the largest and most comprehensive programs in the world, and has developed a multidisciplinary approach that includes an Intestinal Rehabilitation and Nutrition Support program that coincides with the surgical and transplantation aspect.

The establishment of an integrated intestinal rehabilitation and transplantation program provides patients with a unique opportunity to be evaluated, supported and treated by a world class team of medical and surgical specialists in gastrointestinal diseases, PN experts and transplant surgeons in a comprehensive coordinated facility.

About the Program

About the Program

The American Society for Parenteral and Enteral Nutrition (ASPEN) recognizes Cleveland Clinic as a center of excellence in nutrition support. The Digestive Disease and Surgery Institute offers patients with many types of illnesses affecting the gastrointestinal system a comprehensive “one stop service” that includes diagnostic tools, medical treatment, nutrition support and surgical treatment when indicated.

An individual seeking consultation from our intestinal rehabilitation program can expect to go through a comprehensive assessment to determine the absorptive function of the gastrointestinal tract and establish if any nutritional deficiencies exist. A diet prescription can then be personalized based on the structure and function of the remaining gastrointestinal tract. Intensive diet instruction is provided to teach which foods and liquids will be most readily absorbed. Medications are also prescribed to improve digestive and absorptive function of the remaining bowel. A small number of patients have been found to have bowel out-of-circuit as a result of previous surgery. Sometimes, this can be put back into continuity with the rest of the usable bowel, so that absorptive function can be improved.

We can also assist with enhancing bowel adaptation in patients with intestinal failure in order to decrease reliance on parenteral nutrition. Additionally, these patients may be candidates for growth factors to help promote adaptation of the bowels and decrease their reliance on parenteral nutrition.

What We Treat

What We Treat

  • Short bowel syndrome
  • Intestinal failure or severe gastrointestinal dysfunction
  • Inflammatory bowel disease which interferes with maintaining a normal nutritional status
  • Malabsorption syndrome
  • Chronic diarrhea, dehydration or weight loss due to malabsorption
  • Patients who are seeking to reduce or eliminate the need for parenteral nutrition
  • Patients struggling to maintain their weight or nutritional status (including hydration) without relying on intravenous fluid
  • Intestinal disease (e.g., crohn’s disease, radiation enteritis)
  • Patients who need to reduce diarrhea and control stool output
  • Patients who need to gain weight
Meet Our Team

Meet Our Team

Donald F. Kirby, MD, FACP, FACN, FACG, AGAF, CNSC, CPNS

  • Title: Director, Center for Human Nutrition
  • Education: Fellowship: Northwestern Memorial Hospital, Gastroenterology/Nutrition, Chicago, IL
  • Medical School: George Washington University School of Medicine, Washington, DC
    Undergraduate: B.S. with Special Honors in Zoology, George Washington University, Washington, DC
  • Specialty Area: Nutrition Support, Enteral Access
  • Board Certifications: American Board of Internal Medicine; American Board of Nutrition; Gastroenterology Subspecialty Board; National Board of Nutrition Support Certification; American Board of Physician Nutrition Specialists
  • Memberships: American College of Physicians, Fellow; American College of Nutrition, Fellow; American College of Gastroenterology, Fellow; American Gastroenterological Association, Fellow; American Society of Parenteral and Enteral Nutrition; American Society for Clinical Nutrition; American Institute of Nutrition
  • Other: Founding Father of the Virginia Chapter, American Society of Parenteral and Enteral Nutrition; Physician-at-Large (Ohio Society for Parenteral and Enteral Nutrition)

Manal Mahmoud, MD

  • Education: Cleveland Clinic Internal Medicine; Huron Hospital; Medical School - Albaath University
  • Specialty Area: Gastroenterology and Hepatology

Karen Giaco, MS, RD, LD, CNSD

  • Title: Manager, Home Nutrition Support and Center for Gut Rehabilitation and Transplantation
  • Education: MS Nutrition and Dietetics, University of Akron, Ohio; BS Chemistry, John Carroll University, University Heights, Ohio; Coordinated Undergraduate Program: University of Akron, Ohio
  • Specialty Area: Home Parenteral Nutrition, Nutrition Support
  • Other: Member of American Society of Parenteral and Enteral Nutrition; Member of Ohio Society of Parenteral and Enteral Nutrition; Member of Academy of Nutrition and Dietetics; Clinical Nutrition Management DPG; Member of Ohio Dietetic Association

Lisa Moccia, RD, LD, CNSC

  • Title: Center for Gut Rehabilitation and Transplantation Dietitian
  • Education: BS Applied Science Food and Nutrition, Youngstown State University, Ohio
    Coordinated Undergraduate Program, Youngstown State University, Ohio
  • Specialty Area: Intestinal Rehabilitation, Intestinal Transplant, Short Bowel Syndrome, Intestinal Failure, Intestinal Failure-Associate Liver Disease, Small Bowel Bacterial Overgrowth, Renal Oxalate Stones, Plasma Citrulline, Malabsorption, Gastrointestinal Nutrition, Home Nutrition Support, Parenteral Nutrition, Enteral Nutrition, Fluid and Electrolyte Management, Vitamin and Mineral Status, Nutrition-focused Physical Exam, Body Composition
  • Other: Member of Academy of Nutrition and Dietetics; Member of Dietitians in Nutrition Support Group; Member of American Society of Parenteral and Enteral Nutrition

Cassandra Pogatschnik RD, LD, CNSC

  • Title: Center for Gut Rehabilitation and Transplantation Dietitian
  • Education: BS Nutrition and Food, University of Minnesota, Minneapolis/St. Paul
    Coordinated Undergraduate Program, University of Minnesota
  • Specialty Area: Intestinal Rehabilitation, Intestinal Transplant, Short Bowel Syndrome, Intestinal Failure, Intestinal Failure-Associate Liver Disease, Small Bowel Bacterial Overgrowth, Renal Oxalate Stones, Plasma Citrulline, Malabsorption, Gastrointestinal Nutrition, Home Nutrition Support, Parenteral Nutrition, Enteral Nutrition, Fluid and Electrolyte Management, Vitamin and Mineral Status, Nutrition-focused Physical Exam, Body Composition
  • Other: Member of Academy of Nutrition and Dietetics; Member of American Society of Enteral and Parenteral Nutrition

Jill Brown, MS, RD, LD, CNSC

  • Title: Center for Gut Rehabilitation and Transplantation Dietitian
  • Education: BA, Kent State University, Kent, Ohio;
    MS Public Health Nutrition, Case Western Reserve University, Cleveland, Ohio
  • Dietetic Internship: Public Health Nutrition, Case Western Reserve University, Cleveland, Ohio
  • Specialty Area: Intestinal Rehabilitation, Intestinal Transplant, Short Bowel Syndrome, Intestinal Failure--Associated Liver Disease, Small Bowel Bacterial Overgrowth, Renal Oxalate Stones, Plasma Citrulline, Malabsorption, Gastrointestinal Nutrition, Home Nutrition Support, Parenteral Nutrition, Enteral Nutrition, Fluid and Electrolyte Management, Vitamin and Mineral Status, Nutrition-focused Physical Exam, Body Composition, Weight Management, Eating Disorders, Body Image, Nutrition and Mental Health
  • Other: Member Academy of Nutrition and Dieteti

Lindsay Dowhan, MS, RD, LD, CNSC

  • Title: Center for Gut Rehabilitation and Transplantation Dietitian
  • Education: MS Nutrition, Wayne State University, Detroit, MI; Post-Bachelor Certificate, Dietetics, Wayne State University, Detroit, MI; BA Honors Psychology, University of Windsor, Canada
  • Specialty Area: Intestinal Rehabilitation, Intestinal Transplant, Short Bowel Syndrome, Intestinal Failure, Intestinal Failure-Associated Liver Disease, Small Bowel Bacterial Overgrowth, Renal Oxalate Stones, Plasma Citrulline, Malabsorption, Gastrointestinal Nutrition, Nutrition Support, Fluid and Electrolyte Management, Vitamin and Mineral Status, Nutrition-Focused Physical Exam
  • Other: Board Certified Specialist Oncology Nutrition; Member of Academy of Nutrition and Dietetics; Member of Ohio Dietetic Association; Member of American Society for Parenteral and Enteral Nutrition

Sandy I. Austhof, MS, RD, LD, CNSC

  • Title: Center for Gut Rehabilitation and Transplantation Dietitian
  • Education: MS Nutrition, Case Western Reserve University, Cleveland, OH; BS Nutrition and Dietetics, Kent State University, Kent, OH; Dietetic Internship: MetroHealth Medical Center, Cleveland, OH.
  • Specialty: Gut Rehabilitation; Home Parenteral Nutrition; Nutrition-focused physical exam/Malnutrition; Nutrition Support; Gastrointestinal Nutrition
  • Others: Member of American Society for Parenteral and Enteral Nutrition; President-Elect, Ohio Society of Parenteral and Enteral Nutrition; Member of Academy of Nutrition and Dietetics; Member of Dietitians in Nutrition Support.

Tom Pemberton, DTR

  • Title: Center for Gut Rehabilitation and Transplantation Dietetic Technician
  • Education: AAS Dietetic Technology, Cuyahoga Community College
  • Specialty Area: Intestinal Rehabilitation and Transplant Program, Colorectal Surgery, Celiac Disease
  • Other: Member of Academy of Nutrition and Dietetics; Member of Greater Cleveland Academy of Nutrition and Dietetics
Contact Us

Contact Us

9500 Euclid Ave. A10
Cleveland, OH 44195
216.444.5957

If you or a loved one would like a second opinion from a top specialist at Cleveland Clinic, but may be disabled or find it too difficult to travel, we offer MyConsult.  The MyConsult program is an online medical second opinion that connects you to our physician experts who will review your medical records and diagnostic tests to assess your suitability for transplant.