Pediatric Gastroenterology, Hepatology and Nutrition

At the Comprehensive Motility & Abdominal Pain Center at Holtz Children’s Hospital, we are dedicated to improving the lives of our patients and families through personalized diagnostic and treatment options.
Led by our world-renowned pediatric motility specialists, our team uses a multidisciplinary approach, which may include nutritionists, psychologists, social workers, child life specialists and complementary medicine when appropriate.

What is motility?
“Motility” is a term used to describe the contraction of the muscles that mix and propel contents in the gastrointestinal (GI) tract. Any abnormality in the gut muscle and/or nerves, whether from birth or acquired, can disrupt the normal contractions and produce symptoms.

What are the symptoms of a gastrointestinal motility disorder?
Symptoms may include frequent and regular:

• Difficulty swallowing
• Choking
• Gagging
• Aspirating
• Vomiting
• Regurgitation
• Chest pain
• Abdominal pain or distension
• Constipation
• Diarrhea
• Incontinence or soiling
• Weight loss

At Holtz Children’s Hospital, we help your child with the following motility testing and therapies:
Testing

• Esophageal manometry
• Antroduodenal manometry
• Anorectal manometry
• Colonic manometry
• 24 hours pH-impedance study
• Gastric emptying studies

Therapies

• Internal anal sphincter chemodenervation with botulinum toxin
• Endoscopic pyloric injection of botulinum toxin
• Endoscopic lower esophageal injection of botulinum toxin
• Esophageal balloon dilatation
• Biofeedback
• Antegrade continence enema surgery

World Renowned Hepatology, Liver failure, intestinal rehab and transplant program; In addition ao liver and intestinal transplant, our board certified hepatologists specialize in various pediatric liver diseases such as primary sclerosing cholangitis (PSC), autoimmune hepatitis, Wilson’s disease, metabolic diseases, biliary atresia, nonalcoholic fatty liver disease (NAFLD) and acute liver failure.

Holtz Children’s Hospital is a designated William’s Disease Center of Excellence.

Inflammatory Bowel Disease (IBD) – As with any chronic condition, the impact of Crohn’s and ulcerative colitis has a significant medical, psychological and social impact on children and teens. Our specialists offer a multidiscipliary approach to care for these patients and their families; providing the very best medical and surgical options, in a compassionate environment.

Food Allergies and food intolerance is a growing problem. Our specialists work with a multidisciplinary team to diagnose conditions such as Celiac Disease, Lactose Intolerance and other food allergies, and develop a personalized treatment and management plan for each patient.

Holtz Children’s Hospital has one of the few multidisciplinary intestinal rehabilitation programs in the United States. The program cares for children with intestinal failure, generally caused by short bowel syndrome. Our multidisciplinary intestinal rehabilitation team of caregivers and researchers includes:

• Board-certified pediatric gastroenterologist
• Board-certified pediatric hepatologist
• Board-certified pediatric surgeons
• Board-certified transplant surgeons
• Pediatric nurse practitioner
• Registered dietitian
• Medical assistant
• Research assistant

What is short bowel syndrome?
Short bowel syndrome is a complex and often devastating disorder caused by the loss of part of the small bowel and the decreased ability of the intestine to absorb nutrition. The loss of bowel can be due to congenital diseases or surgical removal.

Treating short bowel syndrome
Treatment consists primarily of specialized nutrition management aimed at helping the remaining intestines adapt and take on the absorption functions that were lost. Most of these patients depend on parenteral nutrition, the intravenous feeding of special nutritional products.

Before the creation of the advanced intestinal rehabilitation program, the only option for these patients was intestinal/liver transplant. With our program, transplant is an option for patients who fail home parenteral nutrition therapy.

The Center for Intestinal Rehabilitation at the Miami Transplant Institute provides a multidisciplinary framework for addressing complex digestive problems. We focus on restoring the function of the digestive system through various rehabilitative efforts, without resorting to transplant surgery unless it is the best option.

Each of our patients receive customized medical treatment and interventions to restore their digestive tracts. Ultimately, our team’s goal is to help patients minimize, or even eliminate, the need for parenteral nutrition.

When children require a liver or intestinal transplant or more routine abdominal surgery, our pediatric gastroenterologists work closely with pediatric surgeons to ensure they receive the best possible care.