Pediatrics Neurogastroenterology

Pediatrics

Neurogastroenterology:
Motility and Functional GI Disorders

NewYork-Presbyterian is nationally ranked among the top children’s hospitals for 15 years in a row based on the U.S. News & World Report’s 2021-2022 Best Children’s Hospital ranking.

Treatments & Procedures

How We Diagnose Motility and Functional GI Disorders

Motility and functional GI disorders are challenging to diagnose because the symptoms your child may be experiencing, such as abdominal pain, bloating, constipation, nausea, fecal incontinence, or diarrhea, can have a wide range of causes.

At both of our pediatric motility centers, physicians frequently diagnose conditions through highly specialized diagnostic tests that can determine where the GI tract is not working properly.

These include:

  • 3D high-resolution esophageal manometry (a test for esophagus functionality)
  • Endoluminal functional luminal imaging probe (Endoflip™), a minimally invasive technology used during endoscopy to measure the dimensions, movement, and pressure inside the esophagus and other organs.
  • 3D high-resolution anorectal manometry (a test to measure pressure in the rectum and anus)
  • Combined multichannel intraluminal impedance/pH (to assess patients with suspected reflux)
  • Wireless video capsule endoscopy (to examine the lining of the small intestine)
  • Wireless motility capsule to measure whole gut motility
  • Antroduodenal manometry
  • Colonic manometry
  • Bravo® wireless pH monitoring
  • Therapeutic endoscopy

Most children do not require sedation during these procedures, and your child will experience minimal to no discomfort. We take special care to educate you and your child about what to expect during testing. A child life specialist is always available to help your child understand what is going to happen during the evaluation.

Our Approach to Care

Holistic and Comprehensive Care

Motility-and-Functional-GI-Disorders.jpgWe recognize that every child with a motility or functional GI disorder has a unique set of symptoms, circumstances, and needs. We take a holistic approach to care that considers the entire patient, including physical, emotional, and social factors. We strive to partner with patients and their parents in shared decision-making, empowering them with knowledge, support, and the most effective treatment options to achieve the best possible outcome for every child.

Multidisciplinary Team Approach to Care

Most children with a motility or functional GI disorder respond to a combination of treatments, not just one, which is why we take a multidisciplinary yet individualized team approach that addresses the whole child. Our multidisciplinary team includes pediatric gastroenterologists, behavioral psychologists, dieticians, pulmonologists, ENT specialists, speech and swallow specialists, and surgery specialists who collaborate to manage the medical, psychological, and social needs of patients with motility and functional GI problems.

Patient Support and Wellness Services

For young patients, a digestive disease can affect their daily routine, diet, social interactions, and even time spent learning. At NewYork-Presbyterian, the care of children and adolescents with digestive diseases and disorders goes beyond diagnosis and treatment to include numerous support and wellness services. These include:

  • Nutritional counseling
  • Genetic counseling
  • Educational and emotional support
  • Peer-based experience sharing through our 1-to-1 patient support program
  • Transitional care as an adolescent approaches adulthood

Continuity of Care throughout the Lifespan of the Child

At NewYork-Presbyterian, a vital aspect of our digestive disease program is continuity of care. Children who have a lifelong need for specialized care, such as those diagnosed with motility and functional GI disorders, are embraced by our care teams. We understand the continuous needs of patients regardless of age and are vested in making certain that the transition from childhood to adulthood is simplified by not needing to change care teams. Our integrated care team seamlessly transitions patients from childhood through the teen years and early adulthood. When the time comes, we help our patients transition to NewYork-Presbyterian adult care practitioners.

How We Treat Motility and Functional GI Disorders

If your child receives a diagnosis of a motility or a functional GI disorder, our multidisciplinary teams that includes pediatric gastroenterologists, pediatric surgeons, and other specialists, collaborate to set a treatment plan for your child. We use medical and behavioral therapies as our first line of treatment. If these are not helpful, we may try therapeutic endoscopy, nonsurgical options such as IB-Stim®, or surgery. We also offer integrative medicine modalities such as acupressure, acupuncture, and hypnosis, which have been shown to be very effective in children with motility disorders.

Treatment for motility or functional GI disorders may include:

  • Pharmacologic therapies
  • Non-pharmacologic options
  • Behavioral therapies
  • Therapeutic endoscopy
  • Biofeedback for fecal incontinence
  • Injection of Botox in gastrointestinal sphincters for some esophageal, anorectal and gastric disorders
  • IB-Stim®, a nonsurgical device that sends gentle electrical impulses into cranial nerve bundles located in the ear. This stimulation targets brain areas involved in processing pain and aids in the reduction of functional abdominal pain associated with Irritable Bowel Syndrome.

Why choose us

Nationally Ranked Children’s Hospitals

Both NewYork-Presbyterian Morgan Stanley Children's Hospital and NewYork-Presbyterian Komansky Children's Hospital are among the nation's leading centers for the diagnosis and treatment of childhood diseases. Both are major referral centers for complex and rare digestive disorders in infants, children, and adolescents.

Expertise in Diagnosing and Treating Pediatric Motility and Functional GI Disorders

Our pediatric motility specialists have expertise in the diagnosis and treatment of a full range of motility disorders, including congenital or acquired anorectal and esophageal defects such as imperforate anus, esophageal atresia, trachea-esophageal fistula, as well as children with complex underlying conditions and genetic abnormalities such as Marfan syndrome, a disorder of the connective tissue that can result in constipation. Our physicians are often involved in pioneering new treatments and therapies for the motility disorders.
The Forefront of Innovation for Pediatric Motility and Functional GI Disorders
NewYork-Presbyterian’s pediatric motility centers are at the forefront of advances in care:

  • The Pediatric Gastrointestinal Motility Center at New York-Presbyterian Morgan Stanley Children's Hospital is the first pediatric center in the New York metropolitan area to offer the EndoFLIP™, a cutting-edge technology that is used in the evaluation and treatment of children with esophageal motor disorders and strictures. The center is one of the few in the nation to offer antroduodenal manometry to assess the neuromuscular function of the stomach and small bowel for the evaluation of children with feeding intolerance, vomiting, and bloating, and colonic manometry to measure the neuromuscular function of the colon for children who suffer from chronic constipation and encopresis (fecal incontinence).
  • The Pediatric Motility Center at NewYork-Presbyterian Komansky Children's Hospital is the oldest motility center in the tri-state area and also one of few in the nation that offers antroduodenal manometry and colonic manometry.

Access to World-Class Pediatric Specialists

NewYork-Presbyterian has more top pediatric specialists than any other hospital in New York, according to Castle Connolly. Your child's healthcare team has access to all of the various pediatric medical and surgical subspecialists who practice at NewYork-Presbyterian, ensuring that all of your child's medical needs can be addressed.

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NewYork-Presbyterian Morgan Stanley Children's Hospital

NewYork-Presbyterian Komansky Children's Hospital