Neurogastroenterology and Motility Disorders Center
Diagnosing and Treating Pediatric Neurogastroenterology and Motility Disorders
Wireless Motility Capsule Offers Less Invasive Option
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Neurogastroenterology and Motility Disorders Center
At Nationwide Children’s Hospital, we understand that suffering from motility problems can be emotionally difficult for both parents and children. These problems can result in chronic abdominal pain, vomiting, diarrhea, constipation, abdominal distension and difficulty swallowing. It is often difficult to understand the diagnosis and treatment of motility disorders.
In the Neurogastroenterology and Motility Disorders Center, our specialists work together to focus on the complex interactions between the nervous system and the gastrointestinal (GI) tract. Children with digestive nerve and motility disorders 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 strives to give families answers and treatment options.
Families travel from around the world to receive care from our experts in pediatric GI motility disorders. These unique physicians specialize in evaluating and caring for children with disorders of gut-brain interaction and GI motility disorders.
Nationwide Children's Hospital is ranked by U.S. News & World Report for Gastroenterology and GI Surgery.
Conditions We Treat
From difficulty swallowing and vomiting to constipation and stool accidents, our neurogastroenterology and motility disorders specialists understand the conditions that lead to chronic digestive issues.
The team uses a comprehensive biopsychosocial approach, which includes a child psychologist, dietitian and social worker, to care for children with complex disorders of gut-brain interaction and GI motility disorders, including:
- Achalasia – when there are problems with the nerve cells in the muscles of the esophagus
- Chronic constipation – a condition when a person has difficulty passing stool regularly
- Cyclic vomiting syndrome – sudden, recurring episodes or attacks of vomiting
- Esophageal atresia – a birth defect when the esophagus is divided into two separate parts that don’t connect so food can’t pass from the mouth to the stomach
- Esophageal motility disorders – conditions that affect how the esophagus moves food and liquids
- Fecal incontinence – accidentally having bowel movements
- Functional abdominal pain – when chronic or frequent abdominal pain interferes with regular activities and daily life
- Functional dyspepsia – a disorder of the nerves of the stomach that can cause nausea and vomiting
- Gastroesophageal reflux disease – frequent spitting up, regurgitation, or heartburn
- Gastroparesis – a condition that causes food and liquid to stay in the stomach for a long time
- Hirschsprung disease – a congenital condition that causes blockage of the colon
- Irritable bowel syndrome – a disorder of the nerves of the GI tract that causes abdominal pain and urgent or abnormal bowel movements
- Pediatric intestinal pseudo-obstruction – a rare problem when the muscles or nerves of the GI tract don’t move food properly
- Rumination syndrome – a condition involving involuntary regurgitation of food
Diagnostic Tests
The Neurogastroenterology and Motility Disorders Center includes a rich and diverse team of experts not found at other pediatric hospitals. In fact, we use advanced diagnostic techniques that are only offered at a few places in the world.
Our team helps families understand the reasons for their children’s symptoms and offers new hope through advanced treatment of childhood digestive disorders. Some of our leading, innovative approaches include implanting a gastric electrical stimulator to treat chronic gastroparesis, and sacral nerve stimulation, an advanced therapy that provides hope for children experiencing severe bowel or urinary incontinence. Children are diagnosed through the team’s use of advanced motility testing, including:
- Breath testing to check for problems including intolerance of various sugars (such as lactose intolerance) and overgrowth of bacteria in the small intestine.
- EndoFLIP® (endoluminal functional lumen imaging probe), a minimally invasive test that measures the size and pressure inside the esophagus to help diagnose conditions like achalasia (having trouble moving food to the stomach) and dysphagia (trouble swallowing).
- Esophageal impedance and pH monitoring, which measures how much acid and other substances come into the esophagus from the stomach over 24 hours, to test for acid reflux or other types of reflux.
- Gastric emptying scintigraphy studies to track how long it takes for food to leave the stomach and enter the intestines. These tests help diagnose conditions like gastroparesis (when the stomach empties too slowly) or dumping syndrome (when the stomach empties too quickly).
- Manometry studies measure pressure and movement in the digestive tract to help doctors understand how well the muscles in the digestive systems are working.
- Anorectal manometry (with 3D capability) measures muscle movement in the rectum and anus, which helps control bowel movements.
- Antroduodenal manometry measures muscle movement in the stomach and beginning of the small intestine, to find out if food is moving through properly.
- Colonic manometry measures how well muscles and nerves in the colon (large intestine) work, to see how waste is moving through.
- Esophageal manometry tests pressure and muscle contractions in the esophagus, to check how well a child is able to swallow.
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.
Treatments We Offer
In addition to the most advanced diagnostic testing, our team offers a diverse range of non-invasive, endoscopic and surgical treatments for even the most complex GI motility conditions.
Antegrade continence enemas, including Malone appendicostomy or cecostomy flushes, offer a long-term solution to help empty the bowels to manage severe constipation or fecal incontinence. A minor surgery creates an opening that allows enema liquid to go directly into the colon.
Botox injections can temporarily reduce muscle tone to help improve GI motility.
- Anal sphincter Botox injections help to relax the anal sphincter muscles to treat tears in the lining of the anus (anal fissures) and severe constipation.
- Endoscopic pyloric Botox injections relax the muscle at the bottom of the stomach, which controls how food passes into the small intestine. This is used to treat gastroparesis, when the stomach empties too slowly.
Esophageal dilation (balloon dilation) uses a small balloon inserted through the mouth to stretch and widen narrow parts of the esophagus. A narrow esophagus makes it difficult to swallow. It can be caused by conditions like gastroesophageal reflux disease (GERD), eosinophilic esophagitis (EoE), or conditions that a child is born with.
Neuromodulation therapies are treatments that use tiny electrical pulses to stimulate the nerves to reduce pain, ease constipation and relieve nausea or other symptoms.
- Auricular neurostimulation gently stimulates the nerves in the ear to help treat abdominal pain and nausea.
- Gastric electrical stimulation (GES), also called a gastric pacemaker, provides gentle stimulation to stomach nerves to treat conditions like functional dyspepsia and gastroparesis.
- Posterior tibial nerve stimulation (PTNS) modulates the sacral nerve roots that control bladder and bowel function.
- Sacral nerve stimulation (SNS) is offered to children who experience urinary and/or fecal incontinence or chronic constipation.
Pelvic floor biofeedback therapy can help children who have chronic constipation and fecal incontinence by teaching them how to control and strengthen pelvic floor muscles.
Per Oral Endoscopic Myotomy (POEM) is a procedure used to treat children who have trouble eating, swallowing or keeping down food caused by esophageal achalasia. This is a disorder that causes abnormal muscle contractions in the esophagus and poor relaxation at the bottom of the esophagus.
Transanal irrigation (TAI) helps to treat bowel issues like chronic constipation and fecal incontinence by flushing out the bowel with water.
Additional Services
While your child is treated in the Neurogastroenterology and Motility Disorders Center, you may be referred to other clinics or programs at Nationwide Children’s.
Meet Our Team
Members of the Neurogastroenterology and Motility Disorders Center care team represent a variety of medical disciplines, all working closely to diagnose and treat patients. Because all of our specialists are located on the same campus, you’ll have access to everyone in one trip. Our team includes experts who care for children with motility disorders because:
- Our specialists are considered among the best in the world in diagnosing and treating pediatric neurogastroenterology and motility problems.
- We use advanced diagnostic techniques that are only offered at 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.
Our team includes highly trained pediatric physicians and surgeons. The team is skilled in the full range of digestive nerve and motility disorders and remains dedicated to the highest level of care. Every physician specializes in a particular area of the digestive tract, providing patients with in-depth knowledge and understanding of their conditions. These physicians work as a team with pediatric nurse practitioners to diagnose and treat gastrointestinal diseases and disorders.
Our approach includes collaboration with other specialists, such as Child Life specialists, dietitians, radiologists, neonatologists, and behavioral and developmental psychologists, to provide comprehensive, coordinated care for each child.
Our team is here to help your child get back to the life they want to live. Our experts strive to give families answers and treatment options. For children with more complex conditions, we have the resources to develop a care plan for as long as they need one. From surgery to therapy to ongoing follow-up, your team is with you every step of the way.
Related Specialties
Why Choose Nationwide Children’s?
Digestive nerve and motility disorders can be complex. They disrupt life and keep children from school, from friends and from doing what they love. The Neurogastroenterology and Motility Disorders Center at Nationwide Children’s is a global leader in treating gastrointestinal motility and neurogastroenterology problems in children, and the only center in the U.S. with the complete suite of advanced therapies, including neuromodulation, interventional endoscopy, interventional radiology, as well as colorectal and pelvic reconstruction.
Here are some of the many things that sets our program apart:
- Ranked by U.S. News & World Report as one of the leading children’s hospitals for gastroenterology and GI surgery.
- We use advanced diagnostic techniques that are only offered at a few places in the world, such as implanting a gastric electrical stimulator (gastric pacemaker) to treat chronic gastroparesis and sacral nerve stimulation to treat severe constipation and fecal incontinence.
- Complete care. We treat infants, children and young adults at all stages of development, using a comprehensive biopsychosocial approach to address every facet of a child’s well-being. Patients have access to a team of pediatric physicians, nurse practitioners and surgeons who specialize in a particular area of the digestive tract. Our approach includes collaboration with other specialists, such as Child Life specialists, dietitians, radiologists, neonatologists, and behavioral and developmental psychologists, to provide comprehensive, coordinated care for each child.
- Many of the pediatric gastroenterologists currently specializing in neurogastroenterology and motility disorders in the United States received their fellowship training at Nationwide Children’s.
- Ronald McDonald House. Nationwide Children’s Hospital is home to the largest Ronald McDonald House. Conveniently located right on our main campus, just steps away from the hospital, the Ronald McDonald House allows you to remain a part of your child’s care team while providing you a home away from home.
Leading the Way to New Treatments and Outcomes Through Clinical Research
Clinical care and research work together. This helps scientists and doctors to find new treatments and therapies. Clinical studies (also called clinical trials) are common in daily care at Nationwide Children’s. Clinical studies help doctors learn more about conditions and treatment.
The physicians and surgeons at Nationwide Children’s work with other medical professionals and scientists to develop new treatments, improve quality of life and raise the standards of care for all children with motility disorders. This means you might hear about a clinical study that your child might be able to join. This does not mean that your child must join a study. You always have the choice about whether or not to join a study.
Refer a Patient
The Neurogastroenterology and Motility Disorders 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 Neurogastroenterology and Motility Disorders 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 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.