Pediatric Gastroenterology Practice Expands to Meet Need

The Pediatric Gastroenterology section at the Medical College of Wisconsin has experienced significant growth in its practice in recent years, as outreach to address an unmet need has resulted in more and more children coming in for treatment.

According to Colin D. Rudolph, MD, PhD, Medical College Professor and Chief of Pediatric Gastroenterology, the practice grew by about 20% in 2004 alone and the pace is expected to continue at least into the near future.

"Health conditions that fall under the pediatric gastroenterology 'umbrella' vary from very common disorders such as constipation or obesity in children to rare disorders such as liver diseases requiring liver transplantation, inflammatory bowel disease, celiac disease (heightened gluten sensitivity) and other disorders that cause malnutrition, pancreatic disorders, and disorders involving abnormal gastrointestinal motility," said Dr. Rudolph.

Pediatric Gastroenterology is part of the Children's Specialty Group, through which Medical College of Wisconsin faculty physicians provide pediatric care. Dr. Rudolph said the section now handles about 1,200 outpatient visits and 300 inpatient encounters per month.

"In the overall practice, which is combined with Children's Hospital of Wisconsin, we have 14 pediatric gastroenterologists, 5 nurse practitioners, 5 dieticians, 9 nurse clinicians, 3 speech pathologists, and 5 fellows," said Dr. Rudolph.

Sub-Specialty Clinics Develop
"For several of the disorders we have sub-specialty clinics," said Dr. Rudolph. "We have clinics that receive referrals from throughout the region and nation that specialize in inflammatory bowel disease; the evaluation and care of children with feeding disorders; and in GI motility problems, which are disorders where food won't get through the gastrointestinal tract properly or causes severe constipation; a celiac disease clinic; a liver clinic; and a pediatric obesity clinic.

"So on the clinical side we have a range of focused multidisciplinary clinics for both common and unusual conditions. There's an unmet need here due to a lack of numbers of physicians. We have successfully recruited new physicians and this has allowed us to expand our availability for referral in the local community with improved access. This also allowed the establishment of the sub-specialty clinics, and now patients come to us for evaluation from around the region and from around the country."

Medical College research in pediatric gastroenterology has also expanded and has become widely recognized, Dr. Rudolph said. "On the research side, in addition to a very active clinical research program in all of the subspecialty areas, there has been the particular success of Dr. (Subra K.) Kugathasan's program looking at phenotypic-genotypic relationships, which has become a model for that, and we're extending it into other areas.

"We also have a growing strength in basic science with Dr. Alan Mayer, who is studying the developmental biology of the GI tract, and with Dr. Nita Salzman, who is studying the relationships and role of bowel bacteria in health and disease.

"In general, on the research side we're excited by the growth of our basic science efforts that interdigitate with researchers in the Medical College, where collaboration with the work that's being done in the cell biology department, microbiology department and the Human Genetics Center. The thing that is most exciting on the clinical side is the breadth of patients for whom we can provide truly high quality care by faculty that have focused areas of interest and expertise."

Dan Ullrich
HealthLink Contributing Writer

MCW Health News presents up-to-date information on patient care and medical research by the physicians of the Medical College of Wisconsin.