Thriving Against The Odds: Dr. Amanda Hall on Short Gut Syndrome

In the heart of the Health Sciences Building, Dr. Amanda Hall studies a tray of organoids under a microscope.

“They do need a lot of attention and a lot of feeding,” she said, pointing to dot-like points in a gel solution. 

The pediatric surgeon and assistant professor of pediatric general surgery will use those dots to identify factors that help infants overcome short gut syndrome.

The rare condition affects roughly 24 in every 100,000 babies born in Canada, presenting a profound challenge for infants born with insufficient intestinal length or compromised absorptive capacity.

“It’s a very, very long, difficult road,” said Hall. “Often they’re stuck in hospital and there’s no progress happening, so definitely [families] want another option.”

 

Hall’s interest in medicine dates back to the late 1990s in Meadow Lake, Saskatchewan, and a family TV with three channels. In elementary school, she remembered faithfully recording the reality show Life’s Little Miracles, where a camera crew followed patients at Toronto’s Hospital for Sick Children.

“They’d actually go into the operating room and film the surgeries, which was amazing,” she said. “That’s what I wanted to do.”

 

After she was accepted to the University of Saskatchewan’s College of Medicine, Hall met Dr. Grant Miller and Dr. Gordon Zello during her second year of residency. To become a pediatric surgeon, she had to earn her master’s degree, and Miller took the graduate student under his wing, focusing on parenteral nutrition-associated liver disease in infants.

“I just loved research,” said Hall. “I loved the struggle, the unending nights of work, then finally that amazing feeling when you see numbers that make sense.”

It was the beginning of Hall’s deep-dive into the intricacies of the human gut.

 

Right now, half of infants diagnosed with short gut syndrome get better on their own, with the help of intravenous nutrition. A few undergo complex bowel transplants, but close to 38 per cent succumb to the disease.

“They would have what we call failure to thrive,” said Hall. “They don’t gain weight, they have uncontrollable diarrhea, they might have vomiting.”

In this episode, Hall takes us inside her lab to meet her miniature, spherical organs, cultivated from stem cells, mimicking the intricate structure of the human intestine.

“Definitely you become attached to them. They require a lot of work, a lot of time, and a lot of expense,” Hall said.

Hall is exploring the potential benefits of breast milk and probiotics in encouraging growth inside these mini intestines. From there, she hopes to identify specific components that could accelerate the recovery of infants suffering from short gut syndrome.

“We know that breast milk …. helps with our immune function, helps with the actual integrity of the bowel. I’m curious to know does it actually help the bowel grow faster?”

 

For families grappling with the challenges of short gut syndrome, Hall's work offers a beacon of hope.

“The idea of finding a universal cure is not very realistic,” said Hall. “But if we can start identifying different factors to help and improve the process, that’ll be very important.”

She says a multitude of factors affect short gut syndrome, and some drugs are already in development.

“There’s definitely hope on the horizon,” she said.