Pediatric Neurogastroenterology and Motility Program

A Comprehensive Care Program

The Pediatric Neurogastroenterology Program at MassGeneral Hospital for Children (MGHfC) is designed to restore nutritional status and improve bowel function in children with a variety of chronic intestinal problems. We provide family-centered care with support and infrastructure for all aspects of the quality of life of our patients. Our goal is to provide a multidisciplinary approach that offers you and your child a wide range of expertise in the evaluation and treatment of children with severe intestinal disorders including:

• Anorectal malformations
• Chronic nausea and vomiting
• Esophageal motility disorders
• Gastroparesis
• Hirschsprung’s disease
• Intestinal atresia
• Intestinal neuronal dysplasia
• Intractable constipation
• Irritable bowel syndrome and abdominal pain (Tips for Healthy Bowel Movements)
• Radiation enteritis

Specialized Diagnostic Procedures

Our Pediatric Motility Laboratory performs a large number of specialized diagnostic procedures for the evaluation of gastrointestinal motility disorders, including:

• Esophageal manometry
• Colonic manometry
• Anorectal manometry
• Antroduodenal manometry
• PH studies including wireless pH and pH impedance
• Electrogastrography
• Breath testing

Our Multidisciplinary Team

Each child will be evaluated and cared for by a team of experts, including pediatric surgeons, gastroenterologists, nutritionists and nurses. Child psychiatrists, child life specialists and social workers are also readily available to assist in the care of these young patients. We use state-of-the-art equipment to examine the motility of the intestinal tract. Our team works closely with pathologists and radiologists who are experts in these complex conditions.

In collaboration with the nuclear medicine and radiology departments we perform gastric emptying studies as well as gastrointestinal transit studies, and with pathology department support we go beyond in the analysis of tissue samples, including the role of neurotransmitters and Interstitial Cells of Cajal in gastrointestinal motility disorders in children (including motility disorders caused by Inflammatory Bowel Disease).

We are proud of our strong relationship with the surgical department, a relationship that has enhanced our program, creating a multidisciplinary program for the evaluation of patients with complex gastrointestinal motility disorders designed to restore nutritional status and to improve bowel function in children. This collaborative work allows us to perform a great array of diagnostic and therapeutic procedures including tissue biopsies and novel and specialized surgical procedures for gastrointestinal motility disorders refractory to medical treatment.

We also collaborate with the Pediatric Airway, Voice and Swallowing Center evaluating children suffering with symptoms that affect their ability to eat, breathe or speak.

With greater awareness of gastrointestinal motility disorders in children and new technologies for diagnosing and analyzing such conditions, specialists are gaining in their ability to begin treatment earlier in the course of disease while improving the prognosis for many patients.

Cutting-Edge Research

Members of the Neurogastroenterology Program are actively involved in leading scientific research to understand better the causes of intestinal failure.

Our basic science research program aims to understand the development of the enteric nervous system and how abnormalities of nerve cell development in the intestine lead to functional disorders of the intestine, including Hirschsprung’s disease, pseudo-obstruction and abnormal intestinal barrier function. We are also currently studying the potential of isolating and transplanting neuronal stem cells into the intestine for the treatment of intestinal neuropathies such as Hirschsprung’s disease.

We also perform clinical research studies to understand the natural history and treatment outcomes of motility disorders, including gastroparesis, intestinal pseudo-obstruction and intractable constipation.

Members of the Neurogastrointestinal Program are actively involved in leading scientific research to understand better the causes of intestinal failure.

• Our basic science research program aims to understand the development of the enteric nervous system and how abnormalities of nerve cell development in the intestine lead to various types of intestinal dysmotility, including Hirschsprung’s disease and severe constipation.
• We are developing methods to transplant stem cells in order to replace missing or damaged nerve cells in the intestine.
• Using metabolite profiling, we are working to identify novel serum biomarkers associated with colonic contractility and constipation in children.
• We are exploring novel minimally invasive technologies that will enable us to use colonoscopy and laparoscopy to visualize nerve cells in the intestine without the need for rectal or colonic biopsies.
• Using a genetic mouse model, we are studying the causes of Hirschsprung’s-associated enterocolitis in order to develop methods to prevent this serious condition.

Meet the Team

The pediatric neurogastroenterology group is a collaboration of surgical, psychiatric, and nutritional experts.

Medical/Surgical Staff

• Allan M. Goldstein, MD
         Chief, Pediatric Surgery
         Co-Director, Pediatric Neurogastroenterology Program

• Claire Zar-Kessler, MD
         Co-Director, Pediatric Neurogastroenterology Program

• Daniel P. Doody, MD
         Pediatric Surgery

• Janet Brideau, CPNP
         Pediatric Gastroenterology

Child Psychiatrist

• Holly Peek, MD

Child Nutritionist

• Taylor Kingston, RD, LDN, CNSC