Specialized Clinical Services

The division has a long-standing interest in this genetic cause of liver disease in children. It is the most common genetic diagnosis for which children undergo liver transplantation. The division takes care of most of the patients in the midwest and consults on patients from across the country as well as from overseas. Research studies within the division are designed to determine the cause of liver injury in this disorder, to develop predictive diagnostic tests and specific treatment strategies.

The Celiac Disease Center serves children with celiac disease from throughout our region. We closely monitor disease activity, growth and development and anticipate and manage nutritional consequences and extraintestinal manifestations.

The eosinophilic esophagitis program works closely with the team from Allergy and Pulmonary Medicine. EoE management involves continuing assessment and medication adjustment, especially as we are now using treatments other than swallowed fluticasone (Flovent).

Learn more about the Eosinophilic Gastrointestinal Disorders program (EGID):

The esophageal and anorectal motility program specializes in the disorders of motility including Hirschsprung’s disease, constipation, encopresis, and irritable bowel syndrome. This program brings together pediatric gastroenterologists, surgeons and psychologists for clinical care and will begin to examine the recently identified genetic traits that determine susceptibility to Hirschsprung’s disease and neuronal dysplasia syndromes. Services include impedance pH testing, esophageal and anorectal manometry and botulinum toxin (Botox) sphincter treatments. 

The Healthy Start Clinic addresses the medical complications of obesity. It evaluates children with BMIs > 95th percentile for age whose obesity is complicated by nonalcoholic steatohepatitis, polycystic ovarian syndrome, hyperlipidemia, type 2 diabetes, hypertension and/or sleep apnea. We offer an adolescent bariatric surgery program that includes the extensive assessment required before performing bariatric surgery, as well as pre- and post-operative metabolic and digestive management.

The Inflammatory Bowel Disease (IBD) Center cares for nearly 500 children and adolescents with ulcerative colitis and Crohn’s Disease. We offer comprehensive care to our patients with IBD, including advanced imaging, psychology, endoscopy and colonoscopy and, if necessary, surgery. The center is very active in ImproveCareNow, an international initiative to optimize management of childhood IBD.

This program focuses on the medical care and nutritional support of children with a wide variety of metabolic diseases that affect the liver. This includes galactosemia, glycogen storage disease, disorders of iron and copper metabolism such as Wilson’s disease, tyrosinemia and several others.

The division has established a protocol for evaluation of neonates with liver disease, particularly biliary atresia, designed to begin to determine the epidemiology, pathogenesis and management issues. This protocol has been the model for a multicenter nationwide initiative proposed to the Digestive Disease Branch of the National Institute for Diabetes, Digestive Diseases and Kidney Diseases, and the National Institute of Child Health and Development of the NIH as well as the American Liver Foundation. The research program is now examining the possibility that specific genetic mechanisms account for a subgroup of infants with biliary atresia and situs inversus.

The Pediatric Colorectal Center at Washington University provides high-quality care to children with complex colorectal issues, including Hirschsprung Disease and anorectal malformations. We utilize our multi-disciplinary expertise and state-of-the-art technology to provide personalized solutions to improve quality of life for your child and your family. Our bowel management techniques seek to provide an individualized optimal solution.

The center includes clinical providers and support staff with specific expertise in evaluating and managing pediatric patients with intestinal polyposis syndromes as well as their families.

Gastrointestinal (GI) tract polyps in pediatric patients are typically solitary and usually not associated with an increased risk for GI tract or other cancers. However, in some cases GI polyps predispose to cancers and other serious conditions. Some of these are caused by identifiable gene mutations that could affect family members. The SLCH PGPC was established to provide specialized care for the evaluation and management of children with hereditary gastrointestinal tract polyposis and colon cancer syndromes and their families. Dr. Rudnick, who oversees the program, is a board certified pediatric gastroenterologist with 2 decades of experience seeing pediatric patients with intestinal polyps. Together with division partners and SLCH experts in Pediatric Oncology, Genetics, and Surgery, Dr. Rudnick delivers care to children with Familial Adenomatous Polyposis (FAP), Peutz-Jeghers (PJS) syndrome, Juvenile Polyposis Syndrome and other conditions. Children with personal or family medical histories of intestinal polyposis but without a specific syndromic diagnosis can also be evaluated by the PGPC.

The SLCH PGPC is committed to providing comprehensive care supported by the latest research and treatment options.

The Liver Care Center treats all disorders of the liver and biliary system in infancy, childhood and adolescence. The team has each completed advanced hepatology fellowships and work closely with our transplant surgeons. Our center has performed over 300 liver transplants in children since its inception, including 71 in the past five years. 

Now under the direction of Yumirle Turmelle, MD, the division has established a unique center to provide comprehensive specialty evaluation and care for children with liver disease. Our specialized programs and services include pediatric liver transplantation as well as treatment for viral hepatitis, alpha-1-antitrypsin deficiency and metabolic liver disease.