Neurogastroenterology and motility disorders clinic visits at Cincinnati Children’s have increased by 200 percent in the last five years, with referrals on the rise across all diagnoses. This year, program leadership responded by expanding its clinical offerings, welcoming new faculty and broadening the program’s diagnostic testing capabilities through new technologies.

The team provides comprehensive care for patients with motility issues related to problems such as dysphagia, achalasia, feeding disorders, esophageal dysmotility, gastroparesis, pseudo-obstruction, idiopathic constipation and Hirschsprung’s disease. Recognizing that a large percentage of patients with motility issues have a colorectal disorder, the clinical team worked with the Colorectal Center at Cincinnati Children’s to create an additional, multidisciplinary clinic for these children. The service has grown quickly and now offers four clinic days total on both Cincinnati Children’s campuses, with patients traveling from well beyond the hospital’s immediate area for care. 

“This collaboration has proven to be very beneficial for patients, in terms of providing them with team-based care and diagnostic procedures in a timely fashion,” says Ajay Kaul, MD, a pediatric gastroenterologist and director of the Neurogastroenterology and Motility Disorders Program. “Our gastroenterologists, colorectal surgeons, feeding specialists, therapists, nutritionists, behavioral medicine physicians and specialized motility nurses meet twice a month to talk about the patients we share and how to meet their complex medical needs.”

New technology New diagnostic technology is helping the team expand what it is able to offer patients as well. New offerings include:

• Smart pill This capsule-like pill (available to older patients who can swallow it) collects information as it travels through the stomach, small intestine and colon. It transmits data wirelessly, reporting segmental transit times and indicating where delays occur in the gut.
• Endorectal ultrasound This imaging technology detects anatomical abnormalities such as tears and fistulae involving the anus and anal sphincter muscles.
• Endoflip This catheter-based test evaluates the distensibility of different parts of the gut, including sphincters and the esophagus. Cincinnati Children’s will be among the first hospitals to use this technology in pediatric patients in a clinical setting.

With patient volume on the rise, the physician team is expanding – Kaul and pediatric gastroenterologist Khalil El-Chammas, MD, MS, recently welcomed to the faculty Neha Santucci, MD, a fellowship-trained pediatric gastroenterologist who specializes in motility. The program also launched a fellowship training program, with its first fellow joining Cincinnati Children’s in July 2017.

Earlier in the year, Kaul and El-Chammas led a pediatric motility hands-on course in Las Vegas that was attended by 25 clinicians, including 15 physicians, from children's hospitals across the country. The 2018 course will be held April 27-28 in Las Vegas, focusing on esophageal manometry, impedance-pH and anorectal manometry in children. To register, visit laborie.com/education-gi.