Chyme Reinfusion for Type 2 Intestinal Failure

Inclusion Criteria: * Age ≥ 21 years * Able to provide written informed consent * Dependent on parenteral nutrition (PN) * DES/ECF with exposed afferent and efferent limbs visible on the abdominal wall * Minimum of 2 weeks post DES/ECF creation * Distal limb of DES/ECF opening can be intubated by a minimum 24Fr feeding tube (dilatation of orifice strictures is allowable) Exclusion Criteria: * Insufficient distal access channel (distal limb) for device insertion * Bowel obstruction proximal to the DES/ECF * Small bowel obstruction, anastomotic leak, or perforation distal to the DES/ECF (diagnostic procedure such as gastrografin test, fistulograms, or similar must be performed, if there is a distal anastomosis with integrity not previously evaluated, to ensure that the subject is eligible) * Scheduled for DES/ECF reversal within 4 weeks of enrolment date * Current infection with Clostridium difficile colitis * Current infection small intestinal bacterial overgrowth (SIBO) * Signs or symptoms of systemic infection * Pre-existing gastrointestinal motility disorders including slow transit constipation, outlet obstruction, fecal incontinence, and gastroparesis * Metabolic, neurogenic, or endocrine disorders known to cause colonic dysmotility, e.g., multiple sclerosis, Parkinson's disease, hypothyroidism * Known peritoneal metastatic disease prior to DES/ECF closure (acceptable if only discovered at time of closure) * Liver cirrhosis * Hereditary coagulopathy, e.g., von Willebran…