For more information about patient care for these conditions please visit our aerodigestive disorders page on mottchildren.org
Program Director – Dr. Lauren Bohm, Pediatric Otolaryngology
Lynn Driver, Pediatric Speech-Language Pathology
Dr. Andrew Singer, Pediatric Gastroenterology
Dr. Ixsy Ramirez, Pediatric Pulmonology
The University of Michigan C.S. Mott Children’s Hospital has many specialists dedicated to the care of children with aerodigestive disorders, e.g., Dr. Glen Green. These disorders frequently involve problems with swallowing, feeding, airway structure and function, congenital anomalies, and the upper digestive tract. We provide a specialized consultation service in the outpatient Otolaryngology clinic for patients with complex disorders of the aerodigestive tract (nose, mouth, larynx, trachea, lungs, esophagus and stomach). This collaboration is led by Dr. Lauren Bohm of Otolaryngology and provides assessment by pediatric gastroenterology, pediatric pulmonology, pediatric speech specialists, and pediatric surgery in the same clinic to facilitate unified recommendations for the complex problems many patients seen in this clinic have. Recommendations can include further testing, endoscopic procedures, and surgical procedures.
Barrett’s Esophagus Program
Program Director – Dr. George Zacur
Although Barrett’s esophagus is a relatively rare problem in a pediatric age range, we offer both evaluation and endoscopic treatment options. This program is conducted in the context of a larger Adult Gastroenterology Esophageal Disease program.
Celiac Disease Program
Program Director – Dr. Jenny Lee
In the Division of Pediatric Gastroenterology, we are committed to caring for patients and families with celiac disease. Our physicians and nutritionists provide services with screening tests, diagnostic procedures, ongoing health management, education, and support.
Children’s Intestinal Rehabilitation Program
Co - Medical Directors – Dr. James Lopez and Dr. Jacob Bilhartz
Surgical Director – Dr. Meghan Arnold
Children with problems with poor intestinal function that results in the inability to absorb adequate nutrients from the intestine require intensive and specialized care. This care often includes nutrition given via a very large vein by a catheter (usually a Broviac catheter). The care required needs a whole team of specialists which include pediatric gastroenterology, pediatric surgery, social work, dieticians, pharmacists, and nursing along with a good home care company. The care requires close cooperation with the family (who are team members), the medical team, and the home care company. In addition, because some patients require inpatient care, a close working relationship with the inpatient team is established.
Eosinophilic Esophagitis Program
Program Director – Dr. Andrew Singer
Program Coordinator – Keri Gisslen, CPNP
Eosinophilic esophagitis is a disease of the esophagus that appears to have significant overlap with allergic disease and asthma. Some individuals will have identifiable specific allergies to foods which can be eliminated whereas other will have no specific identifiable food allergen. The treatments offered include single food elimination diets, six food elimination diets (milk product, soy, eggs, wheat, peanuts/tree nuts, and shellfish), and swallowed medications – corticosteroids, usually budesonide (Pulmicort). We attempt to individualize treatment plans and minimize the need for endoscopic reevaluation. Currently, the programs efforts are focus on high quality standardized care and quality improvement initiatives. We work with allergists within the University of Michigan and in the community to provide the best possible care.
General Procedure and Advanced Endoscopy Program
For more information about the types of endoscopic procedures we perform please visit our digestive health page on mottchildren.org.
Director of Endoscopy – Dr. George Zacur
Our faculty have worked to develop expertise in administering a wide range of procedures and diagnostic tests. These include pediatric advanced endoscopic procedures, specialized imaging studies, and routine endoscopic procedures.
U-M pediatric gastroenterologists perform approximately 1000 endoscopic procedures each year. Our endoscopy program has been designed to provide safe and efficient care for all patients, whether the procedure is routine or complex.
Intensive Feeding Program Screening Clinic
Program Director - Dr. Amy Drayton, Pediatric Psychology
Laura Sayers, Pediatric Speech-Language Pathology
Dr. Andrew Singer, Pediatric Gastroenterology
Heather Shepard, Nutrition
This clinic was developed to evaluate patients who have applied for entry into the intensive feeding program. Its purpose is to insure that each patient will receive the greatest possible benefit from the intensive feeding program by screening for medical, oral-motor, nutritional, and behavioral issues which would prevent successful completion of the program. Some of the identified issues may require both evaluation and treatment prior to entry into the program. The team’s commitment is to find the best possible treatment path for your child to help them improve their oral intake.
General GI Clinic
Providers - Pediatric Gastroenterology Faculty, Pediatric Gastroenterology Fellows, and Pediatric GI Nurse Practitioners.
Almost any GI complaint, symptom, or disorder can be seen in these clinics. The problems often referred for evaluation to this clinic include abdominal pain, constipation, vomiting, diarrhea, poor growth, difficulty swallowing, and rectal bleeding. The Pediatric Gastroenterology Faculty see patients in their clinics as well as supervise (review) review all visits patients have with Nurse Practitioners; those seen with Nurse Practitioners are, frequently, discussed by phone on the day of the visit or while the patient is still in the clinic. In some circumstances, the patient may be seen by both a nurse practitioner and an attending physician during the same visit. All the Nurse Practitioners are trained in Pediatric Gastroenterology and have clinical experience in Pediatric Gastroenterology. All Pediatric Gastroenterology Fellows (already doctors trained in Pediatrics) are supervised directly in clinic by attending GI physicians who share the evaluation and examination of patients with the fellows. We work hard to provide access to Pediatric Gastroenterology services and, thus, use the availability of nurse practitioners and fellows to provide additional patient visit slots to provide more rapid evaluation.
Inflammatory Bowel Disease (IBD) Program
For more information about patient care for these diseases please visit the IBD page on mottchildren.org
Program Director – Dr. Jeremy Adler
Director of Quality Improvement and Population Management – Dr. Haley Neef
Our IBD program focuses on providing the best possible care for every patient with Crohn’s disease and Ulcerative Colitis. We standardize our care and provide close monitoring of patients with population management to ensure that each patient is receiving the best possible care and to ensure the best possible outcomes. As part of this program we engage in local quality improvement projects which include both our outpatient and inpatient care of patients. We are leaders in the national collaborative ImproveCareNow (ICN) for quality improvement in the care of pediatric patients with inflammatory bowel disease. We collaborate closely with the pediatric surgeons and pediatric radiologists to develop the best possible strategies for diagnosis and treatment. We work to develop standardized care pathways with the surgeons to facilitate effective communication among subspecialists and families.
Pediatric Intestinal Polyposis Program
For more information about GI patient care visit our digestive health page on mottchildren.org.
Pediatric Endoscopic Director – Dr. George Zacur
Medical Director – Dr. Elena Stoffel
Pediatric Genetics Faculty – Dr. Mark Hannibal, Dr. Shane Quiñonez
This program provides medical and genetic assessment for those with polyposis syndromes or a family history of intestinal (small bowel and colonic) polyps. For those that require monitoring or treatment with endoscopy , the care is coordinate with Pediatric Gastroenterology
Program for Quality Improvement and Population Management in Inflammatory Bowel Disease
Director – Dr. Haley Neef
An important part of the care of patients is to develop specific mechanisms for ensuring that we give the best possible care to each of our patients. This process is called quality improvement and can look at many aspects of patient care to make certain that the important outcomes are followed for each patient. Among the items we follow are disease remission and nutritional status. We, also, engage in specific population management for our patients with Inflammatory Bowel Disease which is focused on ways to improve clinical outcomes while streamlining the clinical delivery model to ensure there is value added by the clinical items and interventions we focus on in our IBD care. Dr. Neef is working on identifying ways to reduce hospitalizations and improve outcomes as part of her clinical activities and research interests.