Gastroenterology & Nutrition | Clinical Activities
The Division sees approximately 4,500-5,000 outpatient office visits
each year. Recurrent abdominal pain, constipation, and complicated
gastroesophageal reflux represent common referral complaints. Most new
patient visits encompass one hour for thorough history and physical
exam, review of potential diagnoses, and design of a plan for evaluation
and therapy. Tests, such as blood drawing, ultrasound, upper
gastrointestinal series or unprepped barium enemas can often be
accomplished the day of the initial visit. Results are reviewed that
same day or phoned to the parents within 2 days. The referring physician
receives a detailed report of the findings as well as recommendations.
Regular outpatient office hours are scheduled Monday through Friday. We
are currently seeing patients within 1 week of referral, but can arrange
outpatient visits in our office immediately or within 24 hours, if necessary.
Office Locations
Missouri Baptist Hospital
3009 N. Ballas Road
Doctors Building C, Suite 351
St. Louis, Mo. 63131
(314) 454-6173
St. Louis Children's Hospital
Suite C
#1 Childrens Place
St. Louis, Mo. 63110
(314) 454-6173
The GI division maintains several special interests. Our physicians have
unique expertise in inflammatory bowel disease. Careful diagnostic
investigation, meticulous management, and attention to psychological,
emotional, and physical development form the core of the program. When
necessary, close consultation with pediatric surgeons, pediatric
dietitians, social workers, and psychologists adds to available
resources.
Secondly, the Division has special expertise in hepatic disorders.
Decades of experience with common and rare hepatic diseases establish
the foundation of this program. Ongoing clinical research concerns
interferon therapy of chronic viral hepatitis and unique approaches to
metabolic liver disease, particularly alpha-1-antitrypsin deficiency. A
well-established
liver transplant program
continues the tradition of
offering the most current therapies for liver disorders. We are now
developing a unique center for evaluation and care of children with
biliary atresia, including a multidisciplinary team of pediatric
gastroenterologists, pediatric surgeons, pediatric radiologists,
pediatric pathologists and the pediatric liver transplant surgery team
with nurse coordinator, social worker and a panel of subspecialty
consultants.
Thirdly, the Division provides detailed analysis and care for global and
specific nutritional deficiencies. Problems such as refusal or inability
to eat, weight loss, or failure to grow are often amenable to
intervention. Special diets or nutritional support regimens such as tube
feeding or parenteral nutrition can be designed. Indirect calorimetry is
available to measure energy expenditure and allow for prediction of
nutritional needs.
Invasive procedures are sometimes required for accurate diagnosis and
therapy. In conjunction with
St. Louis Children's Hospital,
the
Division provides a specially designed environment in the Ambulatory
Procedure Center. Upper gastrointestinal endoscopy, colonoscopy,
endoscopic retrograde cholangiopancreatoscopy, suction rectal biopsy,
percutaneous liver biopsy, pH probe studies, motility studies, and
therapeutic procedures such as esophageal dilation are completed in this
special unit. The pediatric nurses have extensive experience in
relieving pre-procedure anxiety, establishing intravenous lines, and
monitoring of patients during and after the procedures. Most of these
procedures can be completed during a half-day stay in the APC with
subsequent discharge home.
The Pediatric transplantation services began at St. Louis
Children's Hospital in 1984 and now include programs
in heart, heart and lung, lung,
kidney, bone marrow, liver and small intestine. At this time, 100
to 120 children are evaluated and more than 65 organ
transplantations are performed annually. The
Pediatric Liver Transplantation Program
currently is responsible for the management of 60 children who
have undergone liver transplantation at our center. Thirteen
transplants have been done in the last 14 months. Live donor and
split liver transplants have been done. Actuarial survival
statistics for this program are excellent.
The division runs weekly conferences designed to develop a
scholarly approach to diagnosis and management of common and
complex pediatric gastrointestinal problems. These sessions
include didactic thematic seminars and multidisciplinary
presentations attended by faculty from the departments of
Pediatrics,
Pediatric Surgery,
Radiology
and Surgical Pathology. Other conferences are dedicated to the
presentation and review of current research projects by fellows or
faculty, to the presentation of a core curriculum which addresses
basic gastrointestinal and hepatic physiology and to the
discussion of research methods in a journal club format. The
division also runs weekly liver transplantation case conferences
with the liver transplantation program headed by Drs. Jeff Lowell
and Ross Shepherd.
Additional opportunities available to members of the division include
clinical and research seminars conducted as part of the Adult
Gastroenterology Fellowship Program, clinical and research seminars
within the Department of Pediatrics and Pediatric Grand Rounds.
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SCHOOL OF MEDICINE
