Gastroenterology, Hepatology, and Nutrition

Liver Disease and Transplantation

CHAM's superior pediatric liver transplant program is built around an outstanding team of pediatric liver specialists, transplant surgeons, nurses, dietitians, social workers and administrators.

Our pediatric liver specialists have extensive experience in all aspects of pediatric liver disease. They utilize the latest available technology for the diagnosis and treatment of viral hepatitis, biliary atresia, fatty liver disease, autoimmune hepatitis, acute liver failure, and various congenital liver conditions

Therapeutic Endoscopy 

Completed in 2012, CHAM's state-of-the-art endoscopy suite and fluoroscopy unit allow us to deliver sophisticated therapeutic endoscopic treatments to very young children and infants. Our modern, child-friendly, specialized facility is a centerpiece of the entire gastroenterology & nutrition division. We are one of the select few pediatric programs in the region to offer endoscopic retrograde cholangiopancreaography (ERCP) and endoscopic ultrasound (EUS) in the evaluation and treatment of pancreatic and biliary disorders. In the event that x-ray or ultrasound imaging is not sufficient to make a definitive diagnosis or therapeutic intervention requires direct visualization, cholangioscopy or pancreatoscopy may be performed. Direct visualization of the bile and pancreatic ducts during ERCP can help obtain biopsy specimens, lead to the diagnosis of abnormalities, and guide stone therapy. Our division is also among the few pediatric programs in the nation to adopt an innovative technique called one-step percutaneous endoscopic gastrostomy. We have performed over 150 of these procedures in pediatric patients, including infants. Pediatric gastroenterologists at CHAM control intestinal bleeding with argon lasers, electrocautery, endoscopic clipping, band ligation, and other non-surgical methods. In addition, we have successfully performed dilations of esophageal, intestinal, and colonic strictures. We achieve excellent outcomes using pneumatic balloon dilation in the treatment of patients with achalasia, a very rare esophageal motility disorder

Intestinal Rehabilitation Center/Short Bowel Syndrome

Infants who have inadequate bowel length and function require cutting-edge nutritional and gastrointestinal expertise in a top-ranked children's hospital such as CHAM. Our physicians excel in diagnosing and treating short bowel syndrome, secondary to congenital abnormalities of the intestine and surgical interventions. Children develop a short bowel syndrome/intestinal failure as a result of various developmental abnormalities such as intestinal atresia and gastroschisis, surgical resections of damaged intestine from conditions such as volvulus and necrotizing enterocolitis or congenital abnormalities such as microvillus inclusion disease. As a result, children do not have adequate intestine to absorb fluids, electrolytes and nutrients to survive and grow. Their nutrition is provided by catheters surgically placed in a major blood vessel and fluid and nutrients are then provided by a pump. These conditions require a multidisciplinary experienced team such as at CHAM to minimize blood infections and catheter complications; prevent liver injury which results from this treatment; and provide adequate nutrition to permit normal growth and development. Children cared for in the CHAM Intestinal Rehabilitation Center have access to cutting edge research utilizing novel techniques to prevent liver disease and infections. They will also have access to experimental medications such as Teduglutide to improve intestinal function of the remaining intestine.

Fatty Liver Disease

Our Pediatric Fatty liver Disease Center is dedicated to treating children with nonalcoholic fatty liver disease (NAFLD), the most common liver condition in the United States. Our physicians work closely with a team of pediatric radiologists, pathologists, nutritionists, nurses, social workers and child life specialists to provide collaborative, family-centered care. From leading edge tests to innovative research, we are constantly looking to advance care and improve outcomes for children with fatty liver disease.

Aerodigestive Program at Montefiore (ADAM)

The Division of Pediatric Gastroenterology and Nutrition is an integral part of the Aerodigestive Program at Montefiore (ADAM). The Center focuses on the aerodigestive tract, which is made up of the organs and tissues of the respiratory tract and the upper part of the digestive tract. Children seen in our Center may have difficulty swallowing, breathing or gastrointestinal issues with respiratory symptoms. It is a multidisciplinary program and is supported by gastroenterologists (feeding, stomach, liver), pulmonologists (lungs), otolaryngologists, (ear, nose and throat), surgeons, sleep specialists, as well as speech and feeding therapists. Children are managed using advanced diagnostic and treatment techniques. If necessary, combined multispecialty procedures are accomplished in one setting to avoid the need for the administration of anesthesia more than once. All physicians of our team share the patient's record and develop a collective treatment plan.

Gastrointestinal Care of Children with Special Needs

Gastrointestinal dysfunction occurs frequently in children with congenital abnormalities, genetic disorders, metabolic disease as well as neurodevelopmental delay and contributes to poor health and reduced quality of life for them and their caregivers. Comprehensive care of such children requires a multi-disciplinary team. The entire gastroenterology and nutrition division works closely with other specialists at CHAM to help their patients maintain growth, assist in alleviating gastrointestinal symptoms and achieve a higher quality of life. Some of our doctors also have extensive interest and experience in the treatment of disorders like Rett Syndrome. For example, Anthony Loizides, MD, excels in the GI management of children with this disorder.

Inflammatory Bowel Disease 

Crohn's disease and ulcerative colitis are inflammatory conditions of the gastrointestinal tract. Our dedicated team of doctors and nurses are deeply experienced in the treatment of these children. Advanced diagnostic capabilities and treatment methods, together with CHAM's family-centered approach, help them deliver excellent day-to-day care that builds into positive, long-term outcomes.