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Gastroenterology, Hepatology, and Nutrition

Specializing in the treatment of children with complex gastrointestinal and digestive, liver, and nutritional problems.

Duke Children's Gastroenterology, Hepatology and Nutrition provides a comprehensive, multidisciplinary approach to the diagnosis and treatment of gastrointestinal, liver, pancreatic and nutritional disorders.

Among the common disorders we treat are chronic abdominal pain, diarrhea, constipation, and vomiting. Most children occasionally experience one or more of these symptoms. Some children, however, develop recurrent symptoms, which interrupt their normal life, inhibit their development, disrupt their school performance and affect their emotional well being and self-esteem. It is these children who may need the pediatric gastroenterologist's expertise to pinpoint the problem and determine the most effective therapy.

We have broad experience with complex, less common disorders including:

  • Chronic abdominal pain, diarrhea, constipation, and vomiting
  • Inflammatory bowel disease
  • Celiac disease and other forms of chronic diarrhea and malabsorption
  • Gastrointestinal bleeding
  • Acute and chronic liver disease including hepatitis, and disorders requiring liver transplantation
  • Neonatal liver disease
  • Acute and chronic pancreatitis
  • Biliary tract disease
  • Short-bowel syndrome secondary to necrotizing enterocolitis or congenital malformations
  • Complex nutritional problems requiring specialized tube feeding or total parenteral nutrition; placement of percutaneous endoscopic gastrostomy tubes; care of gastrostomy buttons and tubes 
  • Helicobacter pylori infection causing gastritis and duodenal ulcer
  • Inborn errors of metabolism that affect the liver and other parts of the gastrointestinal tract
  • Gastrointestinal manifestations of cystic fibrosis

Our mission is to act as a repository of information and clinical experience for those children and families afflicted with diseases that the pediatric practitioner rarely sees or may not have the means to treat. We are eager to see a patient to provide a second or third opinion, with the hope that our knowledge and the resources of Duke Children's can be mobilized to solve these difficult problems. Having established close cooperation with other divisions within Duke Children's, we can organize comprehensive evaluations for those patients who require the expertise of several specialists.

Areas of particular clinical interest and expertise within our team include Crohn's disease and ulcerative colitis, short-bowel syndrome, chronic liver disease, liver transplantation, infection with Helicobacter pylori, and inborn errors of metabolism that affect the liver.

To increase our knowledge, we are connected to a worldwide electronic bulletin board for pediatric gastroenterology. This bulletin board provides instantaneous consultation with up to 300 professional members and enables us to enlist the help of other experts.

Our Team

Our team Duke Children's consists of a diverse group of dedicated health-care professionals including:

  • Five board-certified pediatric gastroenterologists
  • One pediatric nurse practitioner
  • Four registered nurse clinicians
  • A registered pediatric dietitian
  • A nurse research coordinator
  • Four pediatric endoscopy suite nurses
  • Three administrative assistants
  • One division administrator

Our dedicated pediatric dietitian and other nutritional experts work closely with the Divisions of Allergy/Immunology, Hematology and Oncology, Bone Marrow Transplantation, Endocrinology, Nephrology, Infectious Diseases, and Genetics. This close collaboration is designed to ensure that patients receive the best in nutritional care during their fight against severe chronic diseases through a variety of techniques including:

  • Oral nutritional supplementation
  • Nasogastric or nasojejunal tube feeding
  • Endoscopically placed gastrostomy or gastrojejunostomy tubes
  • Intravenous nutrition through a central venous catheter

We work closely with many home health care companies to allow the chronically ill child in need of special nutritional support to return to the home enviroment as soon as it is possible and medically safe.

Together with the Division of Pediatric Surgery, we consult and manage children with severe gastroesophageal reflux; infants with congenital malformations of the gastrointestinal tract; infants with intestinal, hepatic, and abdominal tumors; and infants and children with obstructions of the bile ducts and pancreatic ducts. We have also recently helped establish a pediatric liver transplantation program that complements Duke's established and highly successful liver transplant program for adult patients.

Treatments

We offer a comprehensive consultative, diagnostic and therapeutic program. We provide easy out-patient access for patients in the Eastern North Carolina region with offices located at Duke Children's Clinic or one of our four outreach clinics.

We perform the following diagnostic and therapeutic procedures:

  • All carbohydrate breath test, including lactose breath test
  • Anal and esophageal manometry
  • Chronic total parenteral nutrition
  • Colonoscopy, flexible sigmoidoscopy and small bowel enteroscopy with biopsies
  • Dilatation of esophageal, and colonic strictures
  • Endoscopic electrocautery, heat ablation and laser therapy of bleeding lesions in the stomach, duodenum, and colon
  • Endoscopic polypectomy
  • Esophageal variceal sclerotherapy and variceal banding
  • Foreign body recovery from the esophagus and stomach
  • Gastrojejunostomy tube placements
  • Pancreatic stimulation test
  • Percutaneous endoscopic gastrostomy
  • Percutaneous liver biopsy
  • Prolonged intraesophageal pH monitoring
  • Small bowel biopsy with measurement of intestinal enzymes
  • Specialized nasogastric and gastrostomy tube feedings
  • Upper gastrointestinal endoscopy with biopsies
  • Video capsule endoscopy
  • Wireless capsule esophageal pH monitoring

We also have a cutting-edge gastrointestinal procedures facility, staffed by four procedures nurses and a technician. Clinical services available at this facility include:

  • EGD and colonoscopy with biopsy, control of bleeding, dilatation, and polypectomy
  • Wireless capsule 48h esophageal pH monitoring
  • Esophageal impedance studies
  • Esophageal and anorectal manometrics
  • Endoscopic retrograde cholangiopanecraticography
  • Endoscopic ultrasound
  • Videocapsule endoscopy for evaluation of the small bowel mucosa

Physicians and Staff

Physicians

Name Areas of Special Interest
Megan W. Butler, MD General pediatric gastroenterology, pediatric hepatology, pediatric transplant hepatology
Nancy M. McGreal, MD Inflammatory bowel disease, transition of adolescents with chronic gastrointestinal illness to the adult health care realm
Leon J. "Yul" Reinstein, MD General pediatric gastroenterology, cystic fibrosis, inflammatory bowel disease, and nutritional deficiencies in complex cases requiring aggressive intervention (including peg placements), GI procedures, management of short-bowel syndrome, celiac disease
Narayanan Venkatasubramani, MBBS General pediatric gastroenterology including the diagnosis and treatment of eosinophilic esophagitis, gastroesophageal reflux disease, celiac disease, pancreatic disease, inflammatory bowel disease

Staff

NameRole
Shannon Morgan Pediatric Nurse Practitioner
Patricia Malone Nurse Clinician
Brandee Rook Nurse Clinician
Susan Soleo Nurse Clinician
Faye Ubinger Nurse Clinician
Catherine Williams Research Nurse Clinical Coordinator

Administrative Staff

NameRole
Joyce Burch Medical Secretary
Sarah Clarke Medical Secretary
Cheryl Chervinko Staff Assistant
Gayle Kerr Administrative Manager

Clinic Hours and Location

Duke Children's Hospital and Health Center
2301 Erwin Road
Durham, NC 27710
Tel: 919-668-4000

Duke Children’s and WakeMed Children's Specialty Services
23 Sunnybrook Road, Suite 200
Raleigh, NC 27610
Tel: 919-862-1200
Hours: Monday - Friday, 8:00 am - 5:00 pm




Appointments and Contact Information

Calls from our patients will be returned within 24 hours by the nurse or physician involved in the patients care.

To schedule an appointment with a Duke faculty physician within the Division of Pediatric Gastroenterology, Hepatology, and Nutrition, please call 919-668-4000.

Our office is open five days a week and can schedule most patients promptly. We guarantee immediate access to a Duke pediatric gastroenterologist, hepatologist, and nutritionist for patients considered emergencies by their primary care physicians.

To be more accessible to our North Carolina patients, we operate the following satellite office:

  • Raleigh: Division of Pediatric Gastroenterology, Hepatology, and Nutrition Clinic at Duke Children's and WakeMed Children's Specialty Services. Please call 919-862-1200.