Diagnosing and Treating Pediatric Gastrointestinal Motility Disorders
Wireless Motility Capsule Offers Less Invasive Option
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At the Motility Center, we understand that suffering from motility problems, which can result in chronic abdominal pain, vomiting, diarrhea, constipation, abdominal distension and difficulty swallowing, can be emotionally difficult for both parents and children. It is often difficult to understand the diagnosis and treatment of motility disorders. Children who suffer from motility problems frequently undergo countless and often invasive tests and procedures to determine a proper diagnosis and treatment. Many times, these tests provide no explanation for the symptoms. Our team of experts strive to give families answers and treatment options.
About the Motility Center
Families travel from across the country and internationally to receive care from our experts in pediatric gastrointestinal motility disorders. These unique physicians specialize in the evaluation and management of previously unexplained causes of pediatric gastrointestinal dysmotility.
From behavioral-related motility problems to complex gastrointestinal disorders, our specialists are pioneering innovative tests and treatments to both help families understand the reasons for their children’s symptoms and give them new hope in the ongoing pursuit of treating childhood digestive disorders. Examples of leading, innovative approaches include the implantation of a gastric pacemaker to treat for chronic gastroparesis, and sacral nerve stimulation, an advanced therapy that provides hope for children experiencing severe bowel or urinary incontinence.
They use a comprehensive biopsychosocial approach, which includes a child psychologist, dietitian and social worker, to care for children with complex GI neuromuscular disorders, including:
- chronic intestinal pseudo-obstruction
- Hirschsprung's disease
- severe chronic constipation
Children are diagnosed through the team's use of advanced motility testing including:
- esophageal impedance
- electronic barostat
These specialized techniques study how the intestine moves, contracts and relaxes. They also can measure intestinal perception, including the threshold for discomfort and pain from the intestine.
Meet Our Team
Our Motility Team is expert in caring for children with motility disorders because:
- Our specialists are considered among the best in the world in diagnosing and treating pediatric gastrointestinal motility disorders.
- We use advanced diagnostic techniques that are only offered a few places in the world.
- We treat patients using a comprehensive biopsychosocial approach.
- We are committed to research to uncover new, more effective treatment options.
Carlo Di Lorenzo, MD, is Chief of the Division of Pediatric Gastroenterology, Hepatology and Nutrition at Nationwide Children's Hospital where he holds the Robert F. and Edgar T. Wolfe Foundation Endowed Chair in Pediatric Gastroenterology and Professor of Clinical Pediatrics at The Ohio State University College of Medicine.
Desale Yacob, MD, is an attending pediatric gastroenterologist, Medical Director of the Motility Center and Director of Gastroenterology and Motility for the Center for Colorectal and Pelvic Reconstruction at Nationwide Children's Hospital.
Many kids will experience occasional bouts of constipation during their childhood. Chronic constipation is a slightly different, yet much more challenging condition to treat.
Chronic intestinal pseudo-obstruction (CIP) is a rare disorder of gastrointestinal motility where coordinated contractions (peristalsis) in the intestinal tract become altered and inefficient. Motility is the term used to describe the contraction of muscles in the gastrointestinal (GI) tract.
Gastroschisis is a defect in the abdominal (belly) wall that forms before the baby is born. Part of the intestine is outside of the baby's body, rather than inside the abdomen. If the defect is small, surgery may be done right away. Larger defects may require a sterile "silo" bag until surgery.
Hirschsprung disease, also known as megacolon, is a congenital condition that causes blockage of the intestine. The blockage is caused by a lack of nerves in the bottom segment of the colon. Children with Hirschsprung disease will need surgery to remove the non-functional segment of the intestine.
Rumination syndrome is a condition where people constantly regurgitate and either vomit or re-swallow their food or drink soon after eating. Rumination syndrome falls into a category of GI conditions called functional gastrointestinal disorders. Symptoms of rumination syndrome can look different from person to person.
Services We Offer
The gastric pacemaker is inserted into the abdomen, with electrical wires leading to the stomach. It sends electrical impulses to stimulate the stomach after eating.
Nationwide Children's is unique in its approach to treating children with retentive fecal incontinence by the placement of minimally invasive percutaneous cecostomy tube.
Esophageal manometry is used to study how the esophagus (swallowing tube) is working. A small tube (catheter) is passed through the nose and into the esophagus.
Colonic manometry is used to study how the colon is working. A catheter is placed in the colon and attached to a computer that records the strength and coordination of muscle contractions in the colon.
Sacral nerve stimulation (SNS) is a promising new technique offered to children who experience urinary and/or fecal incontinence or chronic constipation after other treatments have been unsuccessful. Patients meet with a multi-disciplinary team that determines the individualized treatment plan.
Name: Ella W.
Condition(s): Colonic Neuropathy Pseudo Obstruction, Rectal Dysmotility
Age Today: 12 Years
After 8 months of surgeries, procedures, testing, nasogastric tubes, physical examines, medications, and more, Ella’s condition remained undiagnosed. Until one day she was referred to Nationwide Children’s Hospital.
Name: Allie G.
Condition(s): Rumination Syndrome
Age Today: 21 Years
When Allie was 9-years-old, I started to throw up after almost every single meal. She was put on medicine to help her stomach digest food faster and it worked for a while, but not long.
Name: Carrie W.
Condition(s): Rumination Syndrome
Age Today: 28 Years
When Carrie was 9-years-old, she broke her ankle. This turned into Reflex Sympathetic Dystrophy, a nerve condition that causes severe pain. After years of being told she was faking her pain, she found relief at Nationwide Children's.
Refer a Patient to the Motility Center
Our Motility Center requires a referral from a managing GI provider to ensure they are seen by the appropriate member of our team and facilitate a timely and most comprehensive evaluation. This means that we cannot accept patient self-referrals.
- Referring GI providers can contact the Motility Center by calling (614) 722-3456.
- To assist us in evaluating your patient and determining an appropriate plan of care, without sending the entire patient record, please fax us the following pertinent clinical data to (614) 722-3454:
If the required information listed below has not been received, the referral will become inactive:
- From GI physician, a detailed summary letter outlining patient’s medical history and reason for the referral.
- Patient demographics, including parents' names, current address, and valid phone numbers.
- Copy of insurance card(s), front and back, to include contact information.
- Most recent GI office visit note related to reason for referral; to include most recent height, weight, and date obtained; current medication and allergy lists; and current formula or diet regimen.
- Copy of hospital admission summary relative to the reason for referral to our facility.
- Reports and tracings of all previous GI-related testing, such as:
- Imaging studies (barium enema, upper GI, KUB, sitz marker, ultrasound, MRI, CT scan, gastric emptying, etc.)
- Allergy, thyroid function, sweat chloride, etc.
- Procedures (colonoscopy, manometry, endoscopy, biopsy, ph probes, breath test, etc.)
Once records are received and reviewed, we will contact you with an update on the plan of care that our Motility Team has determined. If motility testing is determined to be indicated, please be aware that we have an approximate four-month waiting list. If you have any questions, please feel free to contact us.
Meet Dr. Desale Yacob: Inside the Motility Center
Dr. Desale Yacob is the Medical Director of the Motility Center at Nationwide Children's Hospital. As Medical Director, he evaluates and helps take care of children referred from around the nation.