Motility / Pseudo-obstruction
Also covered as: Hirschsprung disease · constipation · soiling · outlet obstruction · slow transit constipation · segmental dysmotility · motility disorders · functional constipation
Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Answers come only from this collection's statement ledger and cite the exact moment · not medical advice
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Foundations
2 items
Intestinal rehabilitation: What is intestinal rehab? - Episode 1
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We’re starting a new series about intestinal rehabilitation and all of its intricacies. We’re joined by Drs. Michael Helmrath and Paul Wales, leaders of the Intestinal Rehabilitation Program at Cincinnati Children’s. Hosted by: Todd Ponsky,
video · 14:33 · Dec 2021
Intestinal Rehabilitation, Episode 1: What is intestinal rehabilitation?
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We’re starting a new series about intestinal rehabilitation and all of its intricacies. We’re joined by Drs. Michael Helmrath and Paul Wales, leaders of the Intestinal Rehabilitation Program at Cincinnati Children’s. Hosted by: Todd Ponsky,
podcast · 14:33 · Dec 2021
Diagnosis & Workup
1 item
Colorectal Collaboration: Neurogastroenterology/Motility Disorders
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Pediatric Colorectal Surgery is a team sport. That's why this episode is about how the pediatric colorectal surgery team, lead by Dr. Jason Frischer, collaborates with the neurogastroenterology department at Cincinnati Children's Hospital M
video · 14:55 · Jul 2021
Case-Based Learning
3 items
The Colorectal Quiz Episode 8: Motility Disorders Part 1
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Motility disorder is a team sport - that's why today, we're talking to our colleagues in Pediatric Gastroenterology, Dr. Anil Darbari from Children's National Hospital and Dr. Kahleb Graham from Cincinnati Children's Hospital. Special guest
podcast · 14:04 · Mar 2021
The Colorectal Quiz Episode 9: Motility Disorders Part 2
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Motility disorder is a team sport - that's why today, we're talking to our colleagues in Pediatric Gastroenterology, Dr. Anil Drabari from Children's National Hospital and Dr. Kahleb Graham from Cincinnati Children's Hospital. Special guest
podcast · 13:52 · Apr 2021
Colorectal Quiz: Episode 42 - HD Constipation
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In this episode of the Colorectal Quiz, Drs. Mark Levitt, Jason Frischer, and Chris Gayer discuss a complex case of persistent constipation in a patient with a history of Hirschsprung’s disease. Despite a successful pull-through surgery in
podcast · 14:48 · Dec 2024
In-Depth Reviews
1 item
Intestinal Failure with Dr. Brad Warner
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Discussion with Dr. Brad W. Warner about intestinal failureWhat is intestinal failure?An umbrella term for when the small bowel is unable to digest and absorb an adequate amount of nutrients to sustain a patient through enteral means alone.
podcast · 52:46 · Dec 2020
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Every statement below comes from the recorded discussions, with its speaker and moment.
Intestinal Rehabilitation, Episode 1: What is intestinal rehabilitation?
Intestinal failure is defined as insufficient gut function to absorb enough nutrients, fluids, and calories to support survival and, in children, growth
clinicalPaul Wales2:05 ↗
For a patient to be defined as having intestinal failure, they must have inadequate intestinal function necessitating parenteral support for at least 60 days
guidelineRod Gerardo2:24 ↗
An intestinal rehabilitation program is a multidisciplinary collaborative patient care paradigm that brings coordinated care for children with intestinal failure through comprehensive management of their specialized nutrition and associated needs
clinicalPaul Wales3:03 ↗
Short bowel syndrome is by far the most common category of intestinal failure in pediatric patients
epidemiologicalPaul Wales4:50 ↗
Causes of short bowel syndrome include congenital anomalies such as intestinal atresia, malrotation, volvulus, gastroschisis, and long segment Hirschsprung's disease
clinicalPaul Wales5:06 ↗
Acquired diseases of the newborn such as necrotizing enterocolitis can cause short bowel syndrome
clinicalPaul Wales5:18 ↗
Motility disorders occur when the bowel is unable to push contents through in a coordinated way due to abnormalities of the muscle itself or the nerves that control that muscle
clinicalPaul Wales5:45 ↗
Congenital enteropathies are conditions where the patient has all of their bowel but the mucosa does not work, leading to hypersecretion and profuse fluid losses
clinicalPaul Wales6:17 ↗
Some patients will have elements of two or three categories of intestinal failure in the way they present
clinicalPaul Wales7:11 ↗
A child with gastroschisis could have short bowel because it was not all viable, inflammation affecting absorption, and motility issues
clinicalEllen Encisco7:22 ↗
Older pediatric patients can develop intestinal failure from inflammatory bowel disease or Crohn's disease where they have lost gut as a result of complications
clinicalPaul Wales7:56 ↗
Trauma, malignancy, and vascular thrombosis leading to gut loss are diagnoses seen more in older patients or adult series and less in pediatrics
epidemiologicalPaul Wales8:04 ↗
There are three time points where families reach intestinal rehabilitation programs: prenatal diagnosis, postnatal acquired problems, and later presentations after discharge
clinicalMichael Helmrath8:53 ↗
Prenatal diagnoses that lead to intestinal rehabilitation typically include atresia with cystic fibrosis and gastroschisis
clinicalMichael Helmrath9:15 ↗
Postnatal acquired problems leading to intestinal rehabilitation include volvulus and necrotizing enterocolitis
clinicalEllen Encisco9:29 ↗
Dietitians play a key role in understanding the nutritional needs of children in intestinal rehabilitation
opinionMichael Helmrath11:52 ↗
Social work is a key component of the intestinal rehabilitation team
opinionMichael Helmrath12:01 ↗
The survival overall in big intestinal rehabilitation programs is usually over 90% long-term survival
epidemiologicalRod Gerardo12:34 ↗
Children with intestinal failure who survive long-term now develop chronic comorbidities including renal dysfunction, metabolic bone disease, neurocognitive issues, and quality of life issues
clinicalPaul Wales12:46 ↗
Earlier recognition and taking advantage of the biology of the gut to adapt are time dependent
clinicalMichael Helmrath2:40 ↗
Intestinal rehabilitation streamlines care and improves communication with families and between care providers and team members
opinionPaul Wales3:55 ↗
Intestinal rehabilitation comes down to key factors that drive the process: nutrition in the gut, nutrition in the body, and healing
clinicalMichael Helmrath4:07 ↗
Pattern recognition from multiple eyes on a baby who have seen them over time is important in intestinal rehabilitation
opinionMichael Helmrath4:19 ↗
Intestinal rehabilitation: What is intestinal rehab? - Episode 1
Intestinal failure is defined as insufficient gut function to absorb enough nutrients, fluids, and calories to support survival and, in children, growth
clinicalPaul Wales2:05 ↗
New guidelines define intestinal failure as requiring parental support for at least 60 days
guidelineRod Gerardo2:24 ↗
An intestinal rehabilitation program is a multidisciplinary collaborative patient care paradigm providing coordinated care for children with intestinal failure through comprehensive management of specialized nutrition and associated needs
clinicalPaul Wales3:03 ↗
Short bowel syndrome is by far the most common category of intestinal failure in pediatric patients
epidemiologicalPaul Wales4:50 ↗
Causes of short bowel syndrome include congenital anomalies such as intestinal atresia, malrotation, volvulus, gastroschisis, and long segment Hirschsprung's disease
clinicalPaul Wales5:06 ↗
Acquired diseases of the newborn such as necrotizing enterocolitis cause short bowel syndrome
clinicalPaul Wales5:18 ↗
Motility disorders occur when abnormalities of the intestinal muscle itself or the nerves that control that muscle prevent coordinated movement of food and stool
clinicalPaul Wales5:45 ↗