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Making Things Better for Children with Motility Disorders

NEW YORK (Oct 1, 2012)

Julie Khlevner, M.D.
Julie Khlevner, M.D.

Functional gastrointestinal and motility disorders are common in children and can range from relatively benign conditions such as constipation to more serious diseases such as Hirschsprung's disease. "It is often difficult for a family to understand the diagnoses and treatment of motility disorders. Many children who have motility disorders often undergo multiple tests where few answers are given," says Julie Khlevner, M.D., an expert in pediatric gastroenterology who oversees the new Pediatric Gastrointestinal Motility Center at NewYork-Presbyterian/Morgan Stanley Children's Hospital.

The Center is one of only a handful of pediatric motility centers in the country providing testing, consultative services, and treatment of motility disorder for infants, children, adolescents and young adults. "The Motility Center's purpose is to provide comprehensive care using a multidisciplinary approach and advanced diagnostic techniques with innovative treatment options to help families understand the reasons for their child's symptoms and improve their quality of life."

Motility Conditions Treated

The Pediatric Gastrointestinal Motility Center evaluates and manages conditions resulting from disordered gastrointestinal motility or sensation, including:

  • functional abdominal pain/irritable bowel syndrome
  • gastroesophageal reflux disease (GERD)
  • chronic constipation
  • chronic intestinal pseudo-obstruction
  • achalasia
  • Hirschprung's disease and other congenital anomalies
  • fecal incontinence

"Many different symptoms and signs may be reflective of a gastrointestinal motility disorder," notes Dr. Khlevner. Some of these include:

  • difficulty swallowing
  • heartburn
  • unexplained chest pain
  • persistent nausea and vomiting
  • gastroparesis
  • bloating and abdominal distention
  • weight loss or appetite loss
  • constipation
  • fecal incontinence and soiling

"If a child experiences any of these symptoms, or if he has been treated elsewhere and continues to have these symptoms, it's important for him to be further evaluated here," says Dr. Khlevner.

The Center works closely with referring pediatricians and pediatric gastroenterologists who may have a patient with a suspected gastrointestinal motility disorder who requires further testing, diagnosis, and treatment. "We work together on the patient's treatment plan and establish a collaborative relationship going forward," states Dr. Khlevner.

Advanced Technologies and Treatments

Diagnostic tests and treatments take place in a child-friendly environment and include:

  • anorectal manometry
  • combined multichannel intraluminal impedance/pH
  • esophageal manometry
  • biofeedback for the treatment of fecal incontinence
  • injection of Botox in the gastrointestinal sphincters

"Children experience minimal to no discomfort and most do not require sedation," Dr. Khlevner explains.

Dr. Khlevner and her team take special care to educate and inform parents about their child's condition and what to expect during the testing. "We want the child to be well prepared for what will happen during the examination and testing so that he or she will not be frightened. A Child Life specialist is always available to help children understand their evaluation," she says.

About Dr. Julie Khlevner

Dr. Khlevner, Assistant Professor of Pediatrics at Columbia University Medical Center, received her medical degree from New York Medical College, and completed a residency in Pediatrics at Jacobi Medical Center/Albert Einstein College of Medicine. She then completed a fellowship in pediatric gastroenterology at Stony Brook Long Island Children's Hospital.

For More Information

For more information, please visit the Division of Pediatric Gastroenterology, Hepatology and Nutrition at NewYork-Presbyterian/Morgan Stanley Children's Hospital.

For an appointment, please call (212) 305-5903.

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