• Piper, Hannah


    Investigator, BC Children's Hospital
    Clinical Associate Professor, Division of Pediatric Surgery, Department of Surgery, Faculty of Medicine, University of British Columbia

    Degrees / Designations


    Primary Area of Research
    Healthy Starts
    Secondary Area(s) of Research
    Lab Phone
    Robyn Walker
    Assistant Phone
    Mailing Address

    Ambulatory Care Building
    Room K0-134
    4480 Oak Street
    Vancouver, BC  V6H 3V4

    Affiliate Websites
    Research Areas
    • Intestinal Failure
    • Gut Microbiota
    • Nutrition and Metabolism

    My research is focused on children who have lost a significant amount of their intestine or whose intestines do not function properly. Often these children have difficulty gaining weight and reaching their growth potential. I am interested in determining how changes to the community gut bacteria in these children can impact their growth and metabolism. Ultimately, I want to find treatments to restore a healthy balance of gut bacteria in these children in order to improve intestinal function, overall nutrition, and growth. I am also interested in determining how changes to the gut bacteria impact the body's immune system and overall level of inflammation potentially predisposing children with intestinal failure to infection, liver disease, and blood clots.

    Current Projects

    I am currently conducting a study investigating the use of probiotics as a means to predictably alter the gut microbiota in children with intestinal failure and poor growth. It is unclear whether taking oral probiotics is an effective way to restore balance to the gut bacteria given that many of these patients have rapid intestinal transit and difficulty with absorption. Ultimately, if probiotics prove efficacious, a larger study can be performed to determine the type and duration of therapy that would be most effective.

    I am also involved in a study looking at how the gut microbiota contribute to inflammation in the liver of children with intestinal failure who are dependent on intravenous nutrition (parenteral nutrition). It is well known that some children on prolonged parenteral nutrition develop significant hepatic cholestasis and inflammation but the exact etiology of this is not completely understood. Episodes of sepsis, prematurity, the lack of enteral nutrition, and certain components of the parenteral nutrition are all thought to contribute. Recently, there has been evidence to suggest that the intestinal microbiota may also contribute to hepatic inflammation. In this study, I am trying to correlate the abundance of certain species of intestinal bacteria with abnormal hepatic metabolism of propionate (a short chain fatty acid) in children with short bowel syndrome.

    Another study I am participating in involves determining if children with short bowel syndrome are predisposed to central venous thrombosis. These children frequently require long-term parenteral nutrition necessitating a functional central venous catheter. Unfortunately, they seem to have an increased incidence of central venous thrombosis compared to other patient groups. A preliminary study that I conducted identified a high incidence of acquired thrombophilia in these children due likely to both systemic inflammation and underlying compromised liver function. I am currently studying the best way to prevent venous thrombosis in these patients including screening and potential anticoagulation.

    Selected Publications

    1) McLaughlin CM, Channabasappa N, Pace Jesse, Huanying Q, Piper HG. Growth trajectory in children with short bowel syndrome during the first two years of life. J Pediatric Gastroenterol Nutr, 2017; Sep 26: epub ahead of print.

    2) Blotte C, Styers J, Zhu H, Channabasappa N, Piper HG. A comparison of BroviacÒ and peripherally inserted central catheters in children with intestinal failure. The Journal of Pediatric Surgery, 2017; 52: 768-771.

    3) Gonzalez-Hernandez J, Prajapati P, Ogola G, Channabasappa N, Drews B, Piper HG. Predicting time to full enteral nutrition in children after significant bowel resection. The Journal of Pediatric Surgery, 2017; 52: 764-767.

    4) Piper HG, Fan D, Coughlin LA, Ho EX, Channabasappa N, Kim J, Kim M, Zhan X, Xie Y, Koh AY. Severe gut microbiota dysbiosis is associated with poor growth in patients with short bowel syndrome. The Journal of Parenteral and Enteral Nutrition, 2017; Sep;41(7):1202-1212.

    5) Gonzalez-Hernandez J, Daoud Y, Styers J, Journeycake J, Channabasappa N, Piper HG. Central venous thrombosis in children with intestinal failure on long-term parenteral nutrition. The Journal of Pediatric Surgery, 2016;51: 790-793.

    6) Saeman M and Piper HG. Recent advances in the management of pediatric short bowel syndrome: An integrative review of the literature. Current Surgery Reports, 2016; 4: 1-11.

    7) Swaminathan M, Oron A, Chatterjee S, Piper HG, Cope-Yokoyama S, Chakravarti A, Kapur RP. Intestinal neuronal dysplasia-like submucosal ganglion cell hyperplasia at the proximal margins of Hirschsprung disease resections. Pediatric and Developmental Pathology, 2015; 18: 466-476.

    8) Wales PW, Jancelewicz T, Romao RL, Piper HG, de Silva NT, Avitzur Y. Delayed primary serial transverse enteroplasty as a novel management strategy for infants with congenital ultrashort bowel syndrome. The Journal of Pediatric Surgery, 2013; 48: 993-999.

    9) Piper HG, Wales PW. Prevention of catheter-related blood stream infections in children with intestinal failure. Current Opinion in Gastroenterology, 2013; 29: 1-6.

    10) Piper HG, de Silva NT, Amaral JG, Avitzur Y, Wales PW. Peripherally inserted central catheters for long-term parenteral nutrition in infants with intestinal failure. The Journal of Pediatric Gastroenterology and Nutrition, 2013; 56: 578-581.


    "Role of intestial microbiota in children with intestinal failure and bacterial overgrowth"; APSA Foundation Grant; 7/2014- 7/2015.

    "The role of the intestinal microbiota in the development of cholestatic liver disease in infants with short bowel syndrome"; Discovery Fund Grant; 1/2016- 1/2017.

    "Targeted probiotic therapy to improve the gut microbiota and growth in children with short bowel syndrome"; ASPEN Rhoads Foundation Grant; 1/2017- 1/2018.

    Honours & Awards

    I.B. Holubitsky Memorial Award for the resident demonstrating the highest qualities of surgical excellence; Department of Surgery, University of British Columbia, Vancouver, BC, Canada; 2008.

    F.B. Thomson Award for Outstanding Clinical General Surgeon; Department of Surgery, University of British Columbia, Vancouver, BC, Canada; 2008.

    Provider of the Month Award for the provider who best fulfills the hospital mission; Children's Medical Center, Dallas, Texas; 2016.

    Poster with Distinction, International Pediatric Intestinal Failure and Rehabilitation Symposium; 2016.

    Gut Microbiota Dysbiosis is Associated with Poor Growth in Children with Show Bowel Syndrome; 2015- 2017.

    Research Group Members