Pediatric Gastroenterology, Hepatology and Nutrition

Why choose Ochsner for pediatric Intestinal Rehabilitation Care?

Ochsner Children's Hospital's Intestinal Rehabilitation Care Program is one-of-a-kind in the region and the top choice when you need a gastroenterologist for kids.

Our program is a specialized medical treatment and care program designed to address the unique needs of children with intestinal failure.

Our physicians take a multidisciplinary approach to management, and this is because intestinal conditions often affect more than just the intestinal tract.

Our team of physicians and advanced practice providers have top-quality education, experience and a special interest in caring for pediatric patients with intestinal failure.

Because of Ochsner's holistic approach to care, your child will establish care with many different pediatric subspecialists, including gastroenterologists, surgeons, dietitians, nurses, pharmacists, social workers, speech and language pathologists and behavioral psychologists.

This integrated approach to healthcare has been clinically proven to improve outcomes in children with intestinal failure.

Our collective goal is to deliver the highest quality care to our patients so that they can focus on being healthy, typical children.

What is intestinal failure?

Intestinal failure is a rare and potentially life-threatening condition in which a child's digestive system is unable to absorb the essential nutrients, electrolytes and fluids needed to maintain normal hydration, growth and development.

What causes intestinal failure in kids?

• Major intestinal surgery, the most common cause and most often leads to short bowel syndrome.
• Dysmotility, a condition when the speed, strength and coordination of digestive organs becomes damaged.
• Loss of nutrient-absorption, either at birth or caused by inflammation.

What conditions do we treat?

• Short bowel syndrome caused by conditions, such as:
  • Gastroschisis
  • Hirschsprung's disease
  • Intestinal atresia
  • Malrotation and volvulus
  • Necrotizing enterocolitis (NEC)

• Congenital diarrheal disorders
• Motility disorders and chronic intestinal pseudo-obstruction
• Autoimmune bowel disease
• Pre and post small bowel transplant care
• Complications related to small bowel transplantation
• Intestinal failure-associated liver disease
• Complications around central venous lines, such as infections, thrombosis and loss of access

What are the complications associated with intestinal failure?

While our team works diligently to prevent the following complications, there are a few to be aware of:

• Catheter-related bloodstream infections
• Loss of IV access
• Intestinal failure associated liver disease
• Poor growth and development due to nutritional deficiencies

Meet the Team

Medical Director, Gastroenterologist:

• Jasmeet Mokha, MD, MPH

Surgeons:

• Vincent Adolph, MD
  
• Jessica Roybal, MD
• Rodney Steiner, MD

Advanced endoscopist:

• Matthew Giefer, MD

Hepatologist:

• Ryan Himes, MD

Neurogastroenterologist/Motility:

• Darnna Banks, MD

Palliative Care:

• Michelle Jones, MD

Radiologist:

• Chris Arcement, MD

Pathologist:

• Zachary Dureau, MD

Additional team members:

• Lauren Howley, RN, BSN PED-BC
• Leslie Cenac, RD, LDN
• Lauren Brinks, RD, LDN
• Katie Cook, PharmD, BCPPS
• Mary Beth Chrestman, LCSW

How can I schedule an appointment?

To make an appointment, or for a second opinion, please call 860-545-3900.

Some common pediatric gastroenterology conditions include:

• Abdominal pain

• Abnormal liver blood tests

• Celiac disease — an immune system reaction to eating the protein gluten

• Complications of cystic fibrosis

• Congenital causes of liver disease — including biliary atresia (scarred and blocked bile ducts), Alagille syndrome (not enough bile ducts to drain bile), congenital hepatic fibrosis (abnormally developed bile ducts that can cause liver scarring)

• Constipation

• Cyclic vomiting syndrome — severe and sudden periods of vomiting and nausea

• Diarrhea

• Failure to thrive — low weight as compared to other children of their age and sex

• Fatty liver disease — too much fat in the liver

• Inflammatory bowel disease

• Irritable bowel syndrome

• Jaundice

• Neonatal cholestasis — slow or stopped flow of bile from the liver to the intestines in babies

• Pancreatitis

• Peptic ulcer disease — sores in the lining of the intestine or stomach

• Reflux — stomach contents flow into the esophagus, which leads to stomach or chest pain, vomiting, burping and indigestion

• Short bowel syndrome — the small intestine is too short, preventing the child from getting enough nutrients from food

• Viral hepatitis — liver inflammation caused by exposure to someone or something with the hepatitis virus

A few of the advanced treatment options available at Ochsner include:

• Anal Botox — helps the muscles in the anus relax

• Antroduodenal and full colonic manometry

• BRAVO pH studies — a capsule placed at the bottom of the esophagus to diagnose reflux and evaluate for treatment effectiveness

• Colonoscopy and flexible sigmoidoscopy — minimally invasive tests that examine the colon and rectum

• EndoFLIP — a test that uses a probe to measure the size and pressure of the esophagus

• Endoscopic polypectomy — minimally invasive removal of a growth called a polyp

• Esophagogastroduodenoscopy — a minimally invasive evaluation that uses a camera to examine the lining of the esophagus, stomach and part of the small intestine

• Esophageal and anorectal manometry — a test that measures pressure and tightening ability

• Esophageal dilatation — stretching a narrowed part of the tube that allows you to swallow food

• Esophageal varices banding and sclerotherapy — procedures that can treat and prevent bleeding from enlarged veins in the esophagus

• Small bowel endoscopy — minimally invasive evaluation of the small bowel that can start from the mouth or the rectum

• Gastrostomy button care and replacements — an implanted device that allows food or medicine to go straight into the stomach when mouth intake isn’t possible

• IB-Stim — a device that helps reduce abdominal pain caused by irritable bowel syndrome

• Percutaneous liver biopsy — a needle biopsy of the liver

• pH probe studies — determines the amount of stomach acid in the esophagus

• Rectal suction biopsies — a test done in children with long-term constipation to evaluate for the presence of nerve cells in the rectum

• Small bowel video-capsule endoscopy — a capsule containing a camera is swallowed to allow the doctor to view all parts of the gastrointestinal tract

• Specific nutritional therapy for inflammatory bowel disease

• Therapeutic and diagnostic endoscopic retrograde cholangiopancreatography — a test that diagnoses and treats some problems of the bile ducts, gallbladder, liver or pancreas

• Aerodigestive program. Our pediatric aerodigestive care program provides coordinated, comprehensive evaluation and management of complex airway, respiratory and gastrointestinal tract disorders.

• Colorectal program. Our pediatric colorectal clinic is dedicated to providing quality care for pediatric patients living with congenital conditions as well as severe functional constipation (hard, infrequent and difficult to pass bowel movements) or fecal incontinence (inability to control bowel movements).

• Inflammatory bowel disease (IBD) program. We have developed an IBD program based on the ImproveCareNow network, a quality improvement collaborative dedicated to improving remission rates and young patients' lives.

• Intestinal rehabilitation and care program. Our intestinal rehabilitation and care program works closely with families to rehabilitate children’s intestinal function with a goal of eliminating the need for intravenous nutrition.

• Liver program. Our liver program specializes in the diagnosis and treatment of all forms of pediatric liver disease.

• Liver transplant program. Ochsner is the region’s largest and most comprehensive program for pediatric liver transplants. We offer a full range of liver transplant options, including split and reduced livers, as well as living donor liver transplants.

• Pancreas program. The causes and treatments of pancreatitis can be very different in children. Our team applies the most current data to the management of acute recurrent and chronic pancreatitis for our pediatric patients.

• Pediatric feeding and swallowing disorders (PFSD) program. Our team consists of pediatric gastroenterology, nutrition, nursing, social work, speech therapy, occupational therapy, physical therapy and behavioral psychologists. We are highly trained and experienced in managing children with feeding and swallowing difficulties.

• Psychological support. One of the most common causes of abdominal pain in children can be a manifestation of depression, anxiety and other mental health issues. Ochsner integrates psychologists into our gastroenterology clinics to support our patients.

• Therapeutic endoscopy. The therapeutic endoscopy program at Ochsner offers nonsurgical options designed to treat diseases of the biliary tract, pancreas and intestines. Our highly trained team has extensive experience in endoscopic retrograde cholangiopancreatography (ERCP), small bowel enteroscopy, endoscopic stenting and other advanced endoscopic procedures. We have a dedicated endoscopy suite equipped with full pediatric anesthesia coverage.

We’re committed to helping shape the future of pediatric medicine and that means offering patients the opportunity to participate in clinical research trials.

Our research portfolio includes studies of novel medications for children with cholestasis, a condition that stops or slows bile from flowing from the liver, and other liver diseases; registries to improve the care of patients with inflammatory bowel disease; and quality improvement collaboratives for pediatric liver transplantation.

Ochsner provides access to clinical trials and Phase 3 studies for kids with cholestatic disease or other rare genetic causes of liver disease. Other trials, such as the multi-center pancreas study called Innovation in Science Pursuit for Inspired Research (INSPPIRE), look at children with sudden or ongoing pancreatitis. INSPPIRE also tests a mobile intervention, like smartphones or tablets, with a psychologist to help with ongoing pain from pancreatitis, which allows doctors to care for patients from afar.

“We couldn't praise Dr. Mokha and his team enough. My daughter Rue continues to exceed expectations. From the outside, you might not know she isn’t a typical toddler.” - Sarah L, mother of Rue L., an Intestinal Rehabilitation and Care patient at Ochsner Children's

"It was the most peaceful feeling we had knowing she was going to the right place, and she was in the right hands at Ochsner Children's." - Jesse H., father of Amelia H., a liver transplant patient at Ochsner Children's

Yes! We have several expert pediatric gastroenterologists on staff at Ochsner.

When it comes to your baby’s digestive health, trust your gut. If your baby experiences constipation, frequent vomiting or any other gastrointestinal issues, Ochsner is here to help. We treat children for all kinds of digestive conditions and diseases, and no referral is necessary.