Pediatric Neurogastroenterology & Motility Disorders Program

At the Pediatric Neurogastroenterology and Motility Disorders Program, part of the Pediatric Gastroenterology Program at Hassenfeld Children鈥檚 Hospital at 秘密研究所 Langone, we diagnose and provide advanced care for children with motility disorders.

When food does not move properly through the digestive system, your child can experience uncomfortable intestinal contractions that lead to feeding difficulties increasing the risk of malnutrition, pain, reflux, vomiting, or altered bowel pattern in the form of constipation or diarrhea. Normal gastrointestinal motility involves the close coordination of nerves and muscles in the esophagus, stomach, intestines, rectum, and anus. Often, neurogastroenterology problems are caused by conditions involving both the gastrointestinal system and the brain, called disorders of gut鈥揵rain interactions.

Some common symptoms of these conditions include the following:

  • chronic abdominal pain or bloating
  • chronic diarrhea
  • chronic constipation or fecal incontinence
  • difficulty swallowing or the sensation that food gets caught after swallowing
  • chronic nausea
  • chronic reflux or regurgitation
  • chronic vomiting

Conditions We Treat

Our program鈥檚 specialists include pediatric gastroenterologists who are recognized for their expertise in treating a wide range of motility and gut鈥揵rain communication disorders, including the following:

  • achalasia, a condition where the muscles of the esophagus do not relax properly, making it difficult to swallow food
  • constipation, or difficulty passing stools leading to infrequent and painful bowel movements
  • encopresis, or difficulty controlling bowel movements leading to accidental leaking of stools
  • functional diarrhea
  • gastroparesis, in which the stomach takes too long to empty into intestines, leading to slow digestion and abdominal discomfort
  • Hirschsprung disease, a condition in which missing nerve cells in the intestine can lead to problems with bowel movements
  • intestinal dysmotility, in which impaired digestive system muscles slow or prevent the coordination of digestion, which can lead to malnutrition
  • pediatric intestinal pseudo-obstruction, a digestive nerve or muscle problem that causes the intestines to act as if there is a blockage when there is none, causing severe digestive problems
  • rumination syndrome, in which there is unintentional regurgitation and re-chewing of food shortly after swallowing
  • disorders of gut鈥揵rain interaction, such as irritable bowel syndrome and functional dyspepsia, in which connections between the brain and the gastrointestinal system are altered, leading to symptoms of abdominal pain, nausea, bloating, and/or changes in bowel habits without a clear physical cause

Diagnosing Motility Disorders in Children

We carefully evaluate each patient to accurately diagnose the cause of their symptoms, using newer techniques enable our team to precisely diagnose motility and gut鈥揵rain interaction disorders in children. Our program allows testing to be done in a child-friendly, outpatient setting.

We are one of the few programs in the New York region to offer certain minimally invasive diagnostic tests, including the following.

Manometry Studies

For manometry studies, thin tubes with sensors are inserted into the gastrointestinal tract. These tests measure the pressures and determine the strength of the muscular contractions within the gastrointestinal system. We perform the following types of manometry studies:

  • esophageal manometry measures the strength and muscle coordination of the esophagus to help diagnose conditions such as achalasia, gastric outlet obstruction, and ineffective esophageal motility
  • antroduodenal manometry measures the muscular contractions in the stomach and the small intestine to identify conditions such as gastroparesis, pediatric intestinal pseudo-obstruction, and other motility disorders of the small intestine
  • colon manometry measures the strength and muscular coordination of the large intestine to help diagnose constipation and other bowel disorders
  • anorectal manometry measures the muscle and nerve coordination in the rectum and anus to diagnose conditions such as Hirschsprung disease, anal achalasia, and anal sphincter abnormalities
  • 24-hour multichannel intraluminal impedance-pH monitoring measures acid and non-acid reflux in the esophagus over 24 hours

Endoluminal Functional Lumen Imaging Probe

Endoluminal functional lumen imaging probe (EndoFLIP) is a minimally invasive device used during upper endoscopy to measure how well the stomach and esophagus can stretch and move food. It is helpful in the management of conditions such as eosinophilic esophagitis, achalasia, and strictures.

Creating a Treatment Plan

With a personalized approach based on each child鈥檚 specific condition, we create a comprehensive care plan to treat the condition and provide symptom relief. We partner with specialists across Hassenfeld Children鈥檚 Hospital to address specific needs such as pulmonary and aerodigestive medicine, fecal incontinence, and surgical treatment.

Our comprehensive treatment approach includes clinical nutrition; psychology support; non-pharmacological interventions such as IB-stim, a device worn behind the ear to target the areas of the brain tied to functional abdominal pain; cognitive behavioral therapy; biofeedback; and self-hypnosis, which are performed and taught by trained practitioners based on your child鈥檚 unique concern. In addition, The Comfort Ability workshops are offered at Hassenfeld Children鈥檚 Hospital to provide coping strategies for children with chronic symptoms.

Our Team

Center Leadership

Archana S. Kota, MD
Head of Patient Care

Kara G. Margolis, MD
Head of Research

Clinical Support Team

Colleen Salchines, RD, CDN
Isabella Harold, RDN, CDN, CLC
Hannah Gach, BSN, RN, CPN
Felicia Schrecongost, RN
Monique Armstrong, MSW, LCSW

Contact Us

We are located at 160 East 32nd Street, Medical Level, #L3, in Manhattan. You can call us at 212-263-5940.