Nick's storyNick eats like a typical 14-year-old boy, listing common favorites like steak, mashed potatoes, corn on the cob, pizza and breadsticks.  “He eats like crazy,” says his mom, Angela Peppers.

But Nick did not always have a big appetite. In fact he has only recently begun to enjoy all his favorite foods. Nick was born with only half of his intestines, resulting from a rare condition called cloacal exstrophy  In other words, Nick had short gut syndrome.
“I thought I was having a healthy boy,” explains Angela Peppers.  Immediately after delivery, doctors sent Nick to St. Louis Children’s Hospital to undergo surgical repair. 

Surgeons immediately implanted a colostomy bag that re-routes the intestines to an opening in the abdomen, where the bag collects stool.  But wearing a colostomy bag is less than ideal for reasons beyond general inconvenience. Patients with a colostomy bag do not absorb nutrients the way a person with a normal colon might and they experience greater stool frequency.  To compensate for his nutrimental deficit, Nick also needed to wear a permanent central line called a Broviac to deliver vitamins and minerals intravenously. 

Unable to gain weight and grow, Nick struggled during his first 13 years to stay out of the hospital. “With the Broviac central line, it was always infected and we always had hospital stays,” explains Peppers.

Then, doctors at St. Louis Children’s Hospital recommended the Serial Transverse Enteroplasty or STEP procedure.

The STEP procedure is fairly new operation where surgeons lengthen and criss-cross the intestines to allow for more absorption, as well as to slow down the digestive process.  This operation is an alternative to intravenous nutrition, making life much more satisfying to patients with short gut syndrome.  Nick had the procedure when he was 13-years-old and says it has changed his life considerably.

“He eats like crazy now and he couldn’t do that before,” says Peppers.

Prior to surgery Nick was able to eat when he wasn’t feeling too sick, but food would move too quickly through his short bowel for him to absorb nutrients.  The STEP procedure has allowed to him to enjoy a simple part of life most people take for granted.  He no longer relies on the Broviac for nutrition and can now “taste the food in his stomach.” 

Now a 14-year-old, Nick likes trucks, riding four wheelers and playing in the mud, which is a big change from how he had to live before the STEP procedure.  “When I was sick, all I could do was lay there,” says Nick.  Since his procedure Nick has gained weight and grown, which has given him more mobility and a better quality of life.

Nick says he feels right at home at St. Louis Children’s Hospital “I think Children’s Hospital is pretty cool.  You get to do a lot of things.  It’s a lot better if you know everybody and I feel comfortable here. ”

His mom has the same sentiments. “We feel like family.  We have been together for 14 years.  I could not ask for better GI doctors.”

Nick’s hospital experiences have helped him to decide that he wants to work in an emergency room one day, perhaps even here at St. Louis Children’s Hospital.  “I just want job where I can help care for people.”


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