The Neuro-Gastroenterology and Pediatric Motility Center is a nationally recognized institution, one of the few in the country that is dedicated to diagnosing and treating motility disorders and neuro-gastroenterology dysfunction in young children and adolescents.
This center is unique in its expertise in the use of neurostimulators such as IB-STIM for the treatment of functional abdominal pain and Irritable Bowel Syndrome (IBS).
The center offers a non-surgical procedure that provides long-term relief from the pain associated with IBS. This procedure is FDA-approved for children aged 11 to 18. The center boasts a 95% patient satisfaction rate among adolescents treated to date, with all patients experiencing more than 80% relief from their symptoms.
In addition to IBS, the center also treats children diagnosed with a range of other motility disorders. These include achalasia, colonic dysmotility, dysphagia, fecal incontinence, severe constipation and others. The center uses specialized motility studies and technology to identify factors associated with delayed gastrointestinal transit.
The center offers a variety of treatment options. These include Botox® therapy for anal fissures, biofeedback, pelvic floor training and balloon dilation of esophageal strictures. The center also provides esophageal, antroduodenal, colonic, and anorectal manometry, as well as the use of SmartPill and EndoFLIP.
The center is also involved in clinical research. Current research includes collaborations with the Saint Louis University Cystic Fibrosis Center. These collaborations are focused on investigating the connection between cystic fibrosis and gut dysmotility, as well as the effect of laxatives on cystic fibrosis patients with chronic bowel problems.
What is a Gastrointestinal Motility Program?
Gastrointestinal motility refers to the movement of food through the gastrointestinal passage, from the mouth to the anus. In normal pediatric and adolescent population, muscles and nerves of GI tract works together to move food forward so body can absorb nutrients and produce undigested waste byproducts (poop or feces). Any abnormality at any level, muscles, nerves or coordination among them produces abnormal motility.
Abnormal motility can produce long standing debilitating symptoms not responding to conservative management. Symptoms include but not limited to severe intractable constipation, diarrhea, bloating, abnormality in swallowing, abdominal distension, abdominal pain and sometimes life-threatening symptoms. Our motility program provides comprehensive and thorough evaluation of these symptoms and subsequent tailored treatment case by case basis.
We treat children and adolescents with a variety of motility disorders, including those related to:
- Achalasia (abnormally tight muscles in the lower part of the esophagus)
- Anorectal abnormalities (imperforate or buried anus)
- Severe constipation or fecal incontinence (soiling or stool accidents)
- Dysphagia (difficult swallowing) with concern for esophageal dysmotility (abnormal esophageal contractions)
- Gastroparesis (delayed emptying of stomach in small intestine)
- CIPO (Chronic Intestinal Pseudo-obstruction, abnormal motility of intestine causing symptoms such as distension, abdominal pain, vomiting, etc.)
- Colonic dysmotility (severe constipation caused by nerves or muscles in colon)
- Spina bifida/myelodysplasia with associated colonic dysmotility and bowel difficulties
- Spinal cord associated colonic dysmotility and bowel difficulties
- Abnormally fixated spinal cord/tethered spinal cord with absence of colon motility and bowel difficulties
- Hirschsprung disease and motility related issues even after corrective surgery
- Internal anal sphincter achalasia (failure of anal sphincter to open)
But when problems with tissues, nerves or muscles keep the digestive system from working properly (motility disorders), serious and perhaps life-threatening symptoms develop. Our motility program provides accurate diagnosis and comprehensive treatment for children and adolescents with motility disorders.
At SLU, our motility program is:
- The only dedicated state of the art pediatric GI motility program
- Providing full spectrum GI motility tests including advanced technology such as manometry
- Each patient is being reviewed in advance and tests and treatments are tailored per need of a child.
- Multidisciplinary approach including collaboration with surgery, urology, nutrition, primary care providers, social support and GI
We perform the following tertiary motility tests:
- Esophageal manometry
- Anorectal manometry
- Full colonic motility
- Antroduodenal motility
- Wireless motility Capsule
- pH-Impedance tests
- Sitz Marker GI transit study
- Dedicated biofeedback and pelvic floor therapy/anal botox for dyssynergia
- Neuromodulation/IB stim
- EndoFLIP
Research Eminence:
- Patel is a part of the national GI motility society, the American Neurogastroenterology and Motility Society. He also serves on the Neurogastro and Motility Committee of the North American Society For Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN), the national pediatric GI society.
- More than 25 peer review publications in the last three years.
- Position papers and guideline authors on national GI society.
- We are a motility center with the wide range of research interest including esophageal motility disorders, refractory constipation, Hirschsprung’s disease, cystic fibrosis, anorectal disorders and endoflip.