Pediatric Gastroenterology
and Nutrition

Pediatric Gastroenterology and Nutrition

The Division of Pediatric Gastroenterology and Nutrition is a group of dedicated health professionals who care for children suffering from gastrointestinal or liver disorders. Our team is made up of physicians, nurses, nutritionists, a psychologist and receptionists, and offers inpatient and outpatient consultation, as well as follow-up of children with complex gastrointestinal disorders. In addition, we perform a number of different medical procedures and tests that help in the diagnosis and management of children with specific conditions.

History and Milestones

The Division of Pediatric Gastroenterology and Nutrition at the Montreal Children’s Hospital was founded in 1978. In October 1992, the Just For Kids Foundation funded the construction of our pediatric endoscopy suite, where we offer our patients state-of-the-art diagnostic and therapeutic procedures.

As our clinical population has grown, we have created several multidisciplinary clinics, bringing together professionals from different specialty areas, to help provide more comprehensive care to families with children suffering from gastrointestinal and liver disorders.

Services

Specialized programs and clinics: Celiac disease, Cystic fibrosis, Dysphagia, Esophageal atresia and tracheoesophageal fistula, Feeding disorders team and nutrition, Hepatology, Inflammatory bowel disease, Intestinal failure and advanced nutrition team (INFANT), Motility, Pancreas, Polyposis syndromes, and Reflux

Diagnostic procedures offered on site (Montreal Children's Hospital): Endoscopy, Motility testing, pH probes, and Wireless capsule endoscopy

Inflammatory Bowel Disease Clinic

Chronic inflammatory bowel disease (IBD) refers to a number of disorders such as Crohn’s disease or ulcerative colitis that cause inflammation in the gastrointestinal tract.

Our clinic follows over 300 patients suffering from IBD. We offer patients medical, nursing, nutritional and psychological support to help them deal with their illness. Patients benefit from the latest state-of-the-art diagnostic methods, treatment modalities and protocols to monitor disease. One of our nurse clinicians is assigned to each patient and family to provide out-of-hospital support, offer advice and help minimize the need for hospital visits. Our team is also involved in several educational events and research projects in IBD, working in collaboration with the McGill IBD research group.

Useful information and resources for patients and families may be found at:

Crohn’s and Colitis Foundation of Canada

Crohn’s and Colitis Foundation of America

GI Kids

McGill IBD Research Group

Celiac Disease Clinic

Celiac disease is an immune-mediated disorder (conditions that result from abnormal activity of the body’s immune system) in which a person’s intestine reacts to gluten, a protein found in most grains, including wheat, rye and barley. Our Celiac Disease Clinic provides comprehensive care to children diagnosed with this condition. Our team of gastroenterologists and a specialized nutritionist provide state-of-the-art diagnostic modalities and on-going follow-up. Furthermore, we provide continuing education and up-to-date resources about gluten-free diets to our patients’ families. More information on this condition can be found through the Canadian Celiac Association or GI Kids.

Polyposis Clinic

Polyposis syndromes are hereditary conditions that cause polyps to form in a person’s gastrointestinal tract. The Polyposis Clinic provides comprehensive assessment to patients and their families. Children referred to this clinic are assessed by Dr. Terry Sigman, a pediatric gastroenterologist, Dr. William Foulkes, a genetics specialist, and several genetic counsellors. The team works to provide the patient’s family with a unified care plan.

Hepatology (Liver) Clinic

A variety of congenital (from birth) or acquired liver conditions can affect children of any age. Our Hepatology clinic offers a full range of diagnostic services, as well as consultation and follow-up treatment to patients with pediatric liver disease. The clinic’s multidisciplinary team includes gastroenterologists, nurses and nutritionists. Information and resources for patients and families can be found at the Canadian Liver Foundation or GI Kids.

Intestinal Failure and Advanced Nutrition Team (INFANT)

Our Intestinal Failure and Advanced Nutrition Team (INFANT), led by Dr Ana Sant’Ann,was created to provide care to children suffering from various forms of intestinal failure, which happens when the body cannot fully sustain growth through oral nutrition (eating by mouth). Examples of intestinal failure include short bowel syndrome and severe dysmotility of the gastrointestinal tract. Our multidisciplinary team is made up of pediatric gastroenterologists, pediatric surgeons, a general pediatrician, nurse practitioners, a nutritionist, a pharmacist, an occupational therapist, and a social worker. Together, these health professionals aim to improve the quality of care for our patients by providing intensive inpatient care and coordinated follow-up care on an outpatient basis.

Nutritional Clinic

Nutritional problems in children can occur as a result of other complex health conditions. Dr. Ana Sant’Anna provides consultation and comprehensive nutritional care to patients seen by other subspecialty services at the hospital, as well as patients seen by the Complex Care Service team and the Feeding Disorders team. The Feeding Disorders Team is a multidisciplinary group that includes psychologists, occupational therapists, a behavioural specialist and two nutritionists.

Reflux Clinic

The Reflux/ENT clinic is regional referral centre for the management of children with refractory cases of extra-esophageal reflux disease. The group includes otolaryngologists and a gastroenterologist (Dr Veronique Morinville) with a special expertise in disorders of laryngopharyngeal and gastroesophageal reflux.

The Complex Medical Dysphagia Clinic

Dysphagia refers to a condition in which swallowing is difficult. Children referred to our Complex Medical Dysphagia Clinic have feeding and swallowing difficulties that require coordinated care to best understand, diagnose, and optimize the treatment of their conditions. Specialists from multiple disciplines including Dr. Véronique Morinville from Gastroenterology, Dr. Sam Daniel from Otolaryngology, and others from Pediatrics, Psychology, and Occupational Therapy work together to assess and treat patients.

Cystic Fibrosis Clinic

Cystic fibrosis (CF) is a multi-organ condition that may involve the gastrointestinal tract and liver. Dr. Véronique Morinville is the gastroenterology consultant to the Cystic Fibrosis team and provides expertise for CF children with more complex GI symptoms. More information on this condition can be found on the Cystic Fibrosis Foundation website.

Pancreas Clinic

The pancreas is a gland in the abdomen that helps digest food. The Pancreas Clinic offers consultation, diagnosis, treatment and follow-up to patients with both congenital (from birth) or acquired pediatric pancreatic problems. Our multi-disciplinary team consists of a gastroenterologist, a nurse and a nutritionist. More basic information on this condition may be found at GI Kids.

Esophageal Atesia and Tracheo-esphagael Fistla Clinic

Esophageal atresia is a congenital (at birth) malformation of the digestive system, which happens when the esophagus has not developed properly and does not connect to the stomach. It can be accompanied by a tracheoesophageal fistula (TEF), which is an abnormal link between the trachea (where air goes in) and the esophagus (where food goes in).

Even though surgical treatments can be performed after a baby is born, complications over the long term can be varied. Our EA-TEF clinic offers patients and their families multidisciplinary expertise to optimize care and prevent problems in the future. The team is made up of general surgeons, gastroenterologists, an otolaryngologist, a pediatrician, a respirologist, a nutritionist, an occupational therapist, a nurse and a feeding psychologist. More information can be found on the Association québécoise de l’atrésie de l’oeosophage website and the Réseau québécois interuniversitaire d’étude de l’atrésie de l’oeosphage website.

Diagnostic and Therapeutic Endoscopy

An endoscopy is a procedure in which a small camera mounted on a tube is inserted into the digestive tract via the mouth (gastroscopy) or anus (colonoscopy). Our division provides inpatient and outpatient endoscopic procedures for infants and children in order to diagnose various gastrointestinal disorders. Examples of these disorders include celiac disease, inflammatory bowel disease, eosinophilic gastroenteritis, complicated esophagitis, and polyposis syndromes. In addition, we perform therapeutic endoscopic procedures to treat a number of different conditions such as strictures, esophageal varices, gastrointestinal bleeding, foreign body ingestions or polyps. We perform over 800 endoscopies a year.

Wireless Capsule Program

Wireless capsule endoscopy is a non-invasive method of taking images of the small bowel. Patients swallow a pill-shaped camera measuring 21mm x 27mm which captures images of the small bowel every half second. Our division offers this procedure for certain patients who are being evaluated for Crohn’s disease, polyposis syndromes, celiac disease or occult bleeding (bleeding in the gastrointestinal tract).

pH Probes

This procedure is used with some patients to assess the amount of acid in the esophagus. The procedure involves placing a soft flexible wire through an infant’s or child’s nose for 24 hours.

Division Members

Dr. Najma Ahmed, Residency Program Director
Dr. Laurence Chapuy
Dr. Sylviane Forget
Dr. Véronique Morinville
Dr. Ana Sant'Anna
Dr. Richard Schreiber
Dr. Terry Sigman, Division Director

Associate Members
Hélène Bacha, BScN, Clinical Nurse
Josée Bourgela, BScN, Endoscopy and Home Enteral Feeding Nurse
Karen Casey, P.Dt., Nutritionist
Marie-Andrée Latrémouille, BScN, Clinical Nurse
Marta Rodriguez, BScN, Clinical Nurse
Sally Grace Ruiz, Endoscopy Technician and Patient Care Attendant
Marie-Josée Trempe, P.Dt., Nutritionist
Carla Vitali, BScN, , Endoscopy and Home Enteral Feeding Nurse
Sepideh Zargarpour, PhD, Psychologist

Contact Us

Division Director

Dr. Terry Sigman

Postgraduate Medical Education

Residency Program Director
Dr. Najma Ahmed

Advanced Inflammatory Bowel Disease Fellowship Program Director
TBD

Administrative Staff

Residency Program Coordinator
programadmin.pedsgastro [at] mcgill.ca (Gaby Rosarini)
514-412-4400 ext. 22097

MUHC Administrative Assistant
valerie.cameron [at] muhc.mcgill.ca (Valerie Cameron)
514-412-4400 ext. 22437

MUHC Administrative Assistant
caroline.lamorgese [at] muhc.mcgill.ca (Caroline Lamorgese)
514-412-4474

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