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ContrastGastroenterology, Transplant, Hepatology and Nutrition
| Where can you find us? | E4 Paediatric Medical Day Unit (PMDU) |
| Who to contact with questions? | GI and Nutrition
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| Who to contact when you are making a referral? | GI and Nutrition Telephone: 519-685-8354 Dr. John Howard
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Our Program
The Paediatric Transplant Program at Children’s Hospital:
Since 1984, the Children's Hospital has provided care for children from across Canada who have life-threatening liver and bowel diseases. The liver transplant program has a 93% success rate and Children’s Hospital was the first program in Canada to perform living donor transplants, as well as bowel and multi-organ transplants.
Our Mission is:
- To keep the patient's best interest in mind in everything we do.
- To generously educate our young patients and their families about their illnesses and coping mechanisms.
- To remain at the forefront of all the recent scientific developments and healthcare delivery methods in the field.
- To remain connected to the community we serve.
Our Team
Dr. Paul Atkison, |
Dr. John Howard, |
Barbara St.Cyr RN |
Sandy Williams, |
Suzanne Ratko , RD |
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Role of Team Members
Paediatric Transplant Physicians & Surgeons:
The transplant physicians are doctors with specialized training in caring for children with serious liver or bowel diseases that can only be treated with a transplant. These physicians manage the care of children with liver/bowel failure and provide follow-up care for children who have had a transplant. The surgeons perform the transplant operation and participate in all aspects of your child's care.
If your child is referred to us for the evaluation of possible liver transplant, you will be seeing the Professor & Deputy Chief of the Transplant program, Transplant nurse coordinator as well along with one of the gastrointestinal physicians for comprehensive care.
Role of the Paediatric Gastroenterologist:
Your child will be seeing a Paediatric Gastroenterologist if your child has any gastrointestinal, liver or nutrition problems. They will evaluate your child and, if needed, schedule upper and or lower endoscopies which they perform as outpatient procedures. You will be advised as to the time and place where you need to bring your child and the preparation that is needed for them.
Depending on the diagnosis, the gastroenterologists perform various procedures. Some of the common ones are:
- EGD or Esophagogastroduodenoscopy is upper endoscopy for diseases of the Esophagus, stomach and upper small bowel.
- Colonoscopy or lower GI endoscopy for colon diseases.
- PEG or Percutaneous endoscopic gastrostomy, which is a feeding tube, inserted through the abdomen to feed directly through the stomach.
- Polypectomy or removal of polyps
- Biopsies-Liver and Intestinal.
- Banding and cauterization for bleeding guts.
Role of the Paediatric Dietician:
The paediatric dietitian's role includes nutrition support (parenteral and enteral) for acute and chronic illness and the ongoing nutrition education to caregivers and patients for normal growth and development. In addition, specific nutrition education is provided to those with various disease states and disorders. In children's care, the dietitian provides continuity of nutritional care to patients in both outpatient and inpatient settings.
Each registered dietitian (RD) holds a university degree in clinical nutrition and has completed an internship program recognized by the Dietitians of Canada. Our dietitians are registered members of the College of Dietitians of Ontario (CDO) and the Dietitians of Canada (DC).
The dietitian is able to assess, treat and prevent disease/physical conditions using food, vitamin/mineral supplements and/or nutrition support (i.e. enteral nutrition [tube feeding], parenteral nutrition [TPN], and/or modular nutrient mixtures [polycose, amino acids, MCT oil]) as a therapeutic intervention.
The registered dieticians may provide dietary advice and information to patients and families with conditions such as ulcerative colitis, Crohn 's disease, Celiac's disease and constipation and also address the nutrition issues of our Transplant recipients.
Role of the Paediatric Nurses:
The Registered Nurse serves as a clinic facilitator with us. The nurse does the blood work, and the teaching, and works as an endoscopy support nurse on Paediatric Medical Day Unit (PMDU). Teaching and preparation for children needing Remicade ( TNF alpha inhibitor) for the Crohn's disease patients (TB skin test, CXR, PMDU tour, info re. web sites, Remicade pamphlets etc.) The RN also serves as the constipation-remedy teacher/coach.
Nurse Practitioner/Transplant Coordinator:
The nurse practitioner/transplant coordinator is involved in your child's care before and after the transplant. The nurse has Master’s degree and has experience working with children and adults who need liver, bowel or multi-organ transplants. The nurse practitioner works with the transplant team to assess and treat your child's condition and provides your family with the information you will need throughout the transplant process.
Social Worker:
The social worker is available to provide emotional support and counseling to transplant patients and their families. You may find it helpful to discuss personal, financial and family concerns that arise and the social worker can give you information about community resources to help with living expenses and the cost of medications.
