One of the newest additions to the GI team, John M. Rosen, M.D., a pediatric gastroenterologist and director of neurogastroenterology and motility at Arkansas Children's and a professor of pediatrics at the University of Arkansas for Medical Sciences (UAMS), brings neurogastroenterology and motility (NGM) expertise to the program. Based out of Arkansas Children's Northwest in Springdale, Dr. Rosen champions using telehealth to benefit GI patients.
Dr. Rosen was drawn to Arkansas Children's because of the health system's partnership with UAMS and commitment to providing exceptional care in the region. "This place is agile. It's growing fast, and it's got community support," he said. "It's got this nice mix of 'Let's build what the community needs, and let's be academic about it.'"
Adding an NGM sub-specialist allows for more accurate diagnoses of intestinal motility disorders using functional luminal impedance planimetry (EndoFLIP) and manometry. Providers in the region caring for pediatric patients with dysphagia or refractory constipation, history of tracheoesophageal fistula or anorectal malformation, or suspected achalasia or Hirschsprung disease can receive consultations on the latest diagnostic tests, therapies and research.
The expanded Arkansas Children’s GI team also treats patients with retrograde cricopharyngeus dysfunction (no-burp syndrome) and cyclic vomiting syndrome.
Improving diagnostic accuracy prevents unnecessary treatments, saving patients and their caregivers time and money. Manometry and EndoFLIP are often done in conjunction with endoscopy, optimizing patient and provider time. "For example, if a preschooler with autism is refusing food, an endoscopy can identify inflammation, and EndoFLIP can screen for motor dysfunction, all while the patient is sedated and comfortable. We couldn't accomplish that if the patient were awake," Dr. Rosen said.
Research indicates a treatment plan designed around multidisciplinary, integrated care produces the most effective outcomes for DGBI patients.
Arkansas Children's NGM specialists collaborate with primary care providers, gastroenterologists, psychologists and dietitians to facilitate the combination of medical therapies with dietary interventions and psychological treatments. Disorders of gut-brain interaction are often the result of the interplay between physiological, psychological, and environmental factors; therefore, effective therapies include:
Arkansas Children’s benefits from the state’s investment in the infrastructure necessary to make telehealth a viable and effective tool.
"Telehealth is especially useful for diagnosing and managing DGBI," Dr. Rosen said. "Much of our work involves consulting with primary care providers, interviewing patients about abdominal pain and bowel movements, analyzing lab results and discussing findings with caregivers, most of which we accomplish remotely, saving patients and caregivers the burden of traveling to a hospital or clinic."
Manometry and EndoFLIP complement the list of GI services already available in Arkansas, including these advanced endoscopic procedures:
The Arkansas Children’s GI team sees itself as one of many partners collaborating to improve pediatric GI health, offering pediatricians consultations and connecting patients to financial support and mental health services for psychology related to behaviors that can improve their medical condition and experience.