Center Offers Multidisciplinary Services for Children with Inflammatory Bowel Disease

In January, the gastroenterology/nutrition division at St. Louis Children’s Hospital (SLCH) established the Inflammatory Bowel Disease (IBD) Center for children with IBD. According to Robert Rothbaum, MD, the division’s clinical director, the center’s main goal of care is to promote patients’ overall growth and development. 

“Disorders such as Crohn’s disease and ulcerative colitis affect children in all aspects of their lives, including their physical and psychological well-being, educational endeavors, sports activities, and interpersonal relationships with family and friends,” Dr. Rothbaum says. “Resources to address all aspects of care may be difficult for families to access. We wanted to bundle these services in one convenient, efficient setting.”

The center offers office hours on Tuesday mornings from 8 a.m. to noon in Suite C at the hospital. Patients first fill out intake forms that document how they are feeling physically, as well as either an anxiety or depression questionnaire to evaluate their mental status. After a review of their medications and adherence with taking them, patients see either a gastroenterologist or pediatric gastroenterology-trained nurse practitioner for an exam and discussion of their treatment plan. Patients and their families then may see ancillary specialists such as a dietitian, social worker or psychologist, all located within Suite C. When surgery is a treatment option, SLCH pediatric surgeons are available to meet with patients and parents.

“We prepare for our Tuesday clinics with a weekly meeting of the IBD Center team. We discuss the resources patients may need so we can prioritize those for their visits,” says Elizabeth Utterson, MD, SLCH pediatric gastroenterologist. “We know how difficult it is for our patients to miss school and for their parents to take time from work, so our focus is on providing a single location and time for their appointments and providing easy access to any services they need. And because of our morning hours, we often can arrange for IV infusions, blood work and CT scans the same day.”

Karen, whose son, Michael, 14, has ulcerative colitis, is one of the parents finding the IBD Center an efficient solution to her family’s needs. “I always have a lot of questions, especially in regard to diet and nutrition,” says Karen. “At our last appointment—our first experience with the new IBD Center—we were able to talk to the dietitian right away, instead of having to make an appointment and come back at a later date. Since my husband and I take off work and Michael has to miss school when he has appointments, this was a great time savings for us. And I got my questions answered right away.”

Another important aspect of the IBD Center is education of patients and families about inflammatory bowel diseases. The center has multiple educational brochures from the Crohn’s and Colitis Foundation of America (ccfa.org) that discuss diagnosis, treatment, lifestyle modifications, and emotional and social support.

“Everyone involved with Michael’s care has been incredibly patient and willing to answer any questions we have. The first time we saw Dr. Rothbaum, I literally had three pages of questions and comments, and he went through all of them,” says Karen. “Everyone takes that kind of time for us, which we greatly appreciate.”

The IBD Center provides services to current patients of SLCH’s gastroenterology division, and it welcomes referrals from community physicians.

“A study we conducted shows that the time between a child’s initial symptoms and diagnosis of IBD has gone down progressively over the past 30 years. A good part of the credit for that goes to community physicians who quickly recognize something isn’t right with their patients and refer them to us,” says Dr. Rothbaum. “As a result, we see fewer hospitalizations and more outpatient management of these disorders.”

He adds, “We really enjoy the partnership we have with our colleagues in the community. We know it can be challenging for practitioners to coordinate appointments for their patients with the various specialists children need to see. Fortunately, with the support of St. Louis Children’s Hospital, we have the resources available to help coordinate that care.”

For more information about the IBD Center or to refer a patient, contact Children’s Direct at 800.678.HELP (4357).

The IBD Center Team

Robert Rothbaum, MD, clinical director, gastroenterology/nutrition

Elizabeth Utterson, MD, pediatric gastroenterologist

Jenny Scholl, RN, MSN, CPNP, pediatric nurse practitioner

Amy Lamb-Schnitzer, RN, clinical nurse coordinator

Tara Todd, RD, LD, registered pediatric dietitian

Representatives from SLCH pediatric surgery and social work.